Tammy Nethercott

Individual provider Active NPI Early Intervention Provider Agency · Amenia, NY

NPI 1295574085 · NPPES record last updated May 21, 2024

Key facts

NPI
1295574085
Entity type
Individual (NPI type 1)
Primary specialty
Early Intervention Provider Agency 252Y00000X
Practice address
109 Mygatt Rd
Amenia, NY 12501-5300
Phone
(914) 391-2603
NPI assigned
May 21, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Early Intervention Provider Agency 252Y00000X Yes

Addresses

Primary practice location

109 Mygatt Rd
Amenia, NY 12501-5300

Mailing address

109 Mygatt Rd
Amenia, NY 12501-5300
Phone (914) 391-2603

Other providers in Amenia, NY

All providers in Amenia, NY · Early Intervention Provider Agency in New York

Sources for this page

Verify at the official NPI Registry.