1174852123 NPI number — MARTIN DE PORRES SCHOOL FOR EXCEPTIONAL CHILDREN, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174852123 NPI number — MARTIN DE PORRES SCHOOL FOR EXCEPTIONAL CHILDREN, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARTIN DE PORRES SCHOOL FOR EXCEPTIONAL CHILDREN, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MARTIN DE PORRES SCHOOL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174852123
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13625 218TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD GARDENS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11413-2226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
171-852-5341
Provider Business Mailing Address Fax Number:
171-852-5098

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13625 218TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD GARDENS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11413-2226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
171-852-5341
Provider Business Practice Location Address Fax Number:
171-285-2509
Provider Enumeration Date:
12/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DARNOWSKI
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
DIRECTOR: QA / COMPLIANCE
Authorized Official Telephone Number:
17185255649

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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