Provider Demographics
NPI:1558074658
Name:PUZZLE PIECES EARLY INTERVENTION PROGRAM, LTD
Entity type:Organization
Organization Name:PUZZLE PIECES EARLY INTERVENTION PROGRAM, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUZZLE
Authorized Official - Middle Name:PIECES
Authorized Official - Last Name:EIP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-304-1830
Mailing Address - Street 1:1868 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5705
Mailing Address - Country:US
Mailing Address - Phone:347-304-1830
Mailing Address - Fax:
Practice Address - Street 1:1868 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5705
Practice Address - Country:US
Practice Address - Phone:347-304-1830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency