Provider Demographics
NPI:1053612945
Name:NYC DEPARTMENT OF EDUCATION
Entity type:Organization
Organization Name:NYC DEPARTMENT OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JANUARY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:718-849-3845
Mailing Address - Street 1:13110 97TH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1600
Mailing Address - Country:US
Mailing Address - Phone:718-849-3845
Mailing Address - Fax:
Practice Address - Street 1:13110 97TH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1600
Practice Address - Country:US
Practice Address - Phone:718-849-3845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014825-1251300000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY225X00000XMedicaid