Provider Demographics
NPI:1992238034
Name:M.T.C.B . INC
Entity type:Organization
Organization Name:M.T.C.B . INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MA THERESA
Authorized Official - Middle Name:CRUZATE
Authorized Official - Last Name:BIHASA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:516-354-0514
Mailing Address - Street 1:31 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2914
Mailing Address - Country:US
Mailing Address - Phone:516-354-0514
Mailing Address - Fax:
Practice Address - Street 1:31 TERRACE AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2914
Practice Address - Country:US
Practice Address - Phone:516-354-0514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency