Provider Demographics
NPI:1124380571
Name:FLUSHING HOSPITAL MEDICAL CENTER EARLY INTERVENTION PROGRAM
Entity type:Organization
Organization Name:FLUSHING HOSPITAL MEDICAL CENTER EARLY INTERVENTION PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE CORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-206-8549
Mailing Address - Street 1:4559 156TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1724
Mailing Address - Country:US
Mailing Address - Phone:646-279-0711
Mailing Address - Fax:
Practice Address - Street 1:13420 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2619
Practice Address - Country:US
Practice Address - Phone:718-206-8549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency