Provider Demographics
NPI:1417226671
Name:NANCY CORP.
Entity type:Organization
Organization Name:NANCY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AFDAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ELREWENY
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF PT
Authorized Official - Phone:718-415-0383
Mailing Address - Street 1:755 W FINGERBOARD RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2628
Mailing Address - Country:US
Mailing Address - Phone:718-415-0383
Mailing Address - Fax:718-876-4986
Practice Address - Street 1:755 W FINGERBOARD RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2628
Practice Address - Country:US
Practice Address - Phone:718-415-0383
Practice Address - Fax:718-876-4986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019765-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency