NPIMap

Organization Active NPI

Kidtastic Consulting Services, Inc.

  • Early Intervention Provider Agency
  • Lake Grove, NY
National Provider Identifier
1730329459
Registry record updated Feb 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
210765081 Issued in NY
Legal business name
KIDTASTIC CONSULTING SERVICES, INC.
Practice address
62 Birch St
Lake Grove, NY 11755-2743
Phone
(631) 553-7952
NPI assigned
Feb 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2009

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

Authorized official

Name
Mrs. Dawnmarie Garrett, MSEDNPI 1548525074
Title
President
Phone
(631) 553-7952

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 210765081 NY Primary

Addresses

Primary practice location

62 Birch St
Lake Grove, NY 11755-2743

Mailing address

62 Birch St
Lake Grove, NY 11755-2743
Phone (631) 553-7952

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235174400000",
    "number": "1730329459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BIRCH ST",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552743",
            "telephone_number": "631-553-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BIRCH ST",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552743",
            "telephone_number": "631-553-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDTASTIC CONSULTING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-21",
        "last_updated": "2009-02-21",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "DAWNMARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-553-7952",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSED"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "210765081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2009; 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.