Provider Demographics
NPI:1972840189
Name:BEVERLY SUAREZ LLC
Entity type:Organization
Organization Name:BEVERLY SUAREZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEACHER -
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-483-8986
Mailing Address - Street 1:233-15 SEWARD AVE
Mailing Address - Street 2:QUEENS VILLAGE
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2132
Mailing Address - Country:US
Mailing Address - Phone:646-483-8986
Mailing Address - Fax:
Practice Address - Street 1:220-18 HORACE HARDING EXPRESSWAY
Practice Address - Street 2:MARATHON INFANT & TODDLER
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11364
Practice Address - Country:US
Practice Address - Phone:718-423-0056
Practice Address - Fax:718-229-5370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services