Provider Demographics
NPI:1306127626
Name:ASSOCIATION FOR THE VISUALLY IMPAIRED, INC.
Entity type:Organization
Organization Name:ASSOCIATION FOR THE VISUALLY IMPAIRED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBERTH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:845-574-4950
Mailing Address - Street 1:260 OLD NYACK TPKE
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5741
Mailing Address - Country:US
Mailing Address - Phone:845-574-4950
Mailing Address - Fax:845-574-4944
Practice Address - Street 1:260 OLD NYACK TPKE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5741
Practice Address - Country:US
Practice Address - Phone:845-574-4950
Practice Address - Fax:845-574-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY419252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency