Provider Demographics
NPI:1699348094
Name:PROGRAM DEVELOPMENT SERVICES, INC
Entity type:Organization
Organization Name:PROGRAM DEVELOPMENT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORINDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DERBYSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-256-2212
Mailing Address - Street 1:6908 NEW UTRECHT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1810
Mailing Address - Country:US
Mailing Address - Phone:718-256-2212
Mailing Address - Fax:718-256-7433
Practice Address - Street 1:6240 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-1032
Practice Address - Country:US
Practice Address - Phone:718-601-6620
Practice Address - Fax:718-884-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable