Provider Demographics
NPI:1952920423
Name:ID STRIDES INC
Entity Type:Organization
Organization Name:ID STRIDES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:
Authorized Official - First Name:INNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA ED
Authorized Official - Phone:646-280-5680
Mailing Address - Street 1:1740 OCEAN AVE APT 5K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5451
Mailing Address - Country:US
Mailing Address - Phone:646-280-5680
Mailing Address - Fax:
Practice Address - Street 1:1740 OCEAN AVE APT 5K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5451
Practice Address - Country:US
Practice Address - Phone:646-280-5680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency