NPIMap

Organization Active NPI

Interdisciplinary Center for Child Development, Inc.

Doing business as Iccd

  • Developmental Disabilities Clinic/Center
  • Bayside, NY
National Provider Identifier
1285910828
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
INTERDISCIPLINARY CENTER FOR CHILD DEVELOPMENT, INC.
Doing business as
Iccd
Practice address
3555 223Rd St
Bayside, NY 11361-2236
Phone
(718) 428-5370
Fax
(718) 428-5462
NPI assigned
Oct 27, 2011
Last updated
Oct 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. David Locker
Title
Executive Director
Phone
(718) 428-5370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

3555 223Rd St
Bayside, NY 11361-2236

Mailing address

3555 223Rd St
Bayside, NY 11361-2236
Phone (718) 428-5370

Other names 1

  • ICCD Doing business as

National Provider Directory

National Provider Directory

Locations

3555 223rd St
Bayside, NY 11361
Phone (718) 428-5370

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1285910828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 223RD ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612236",
            "telephone_number": "718-428-5370",
            "fax_number": "718-428-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 223RD ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612236",
            "telephone_number": "718-428-5370",
            "fax_number": "718-428-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERDISCIPLINARY CENTER FOR CHILD DEVELOPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "LOCKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-428-5370",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICCD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.