LJ Independent Services Inc.

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

109522413 Issued in NY

Legal business name

LJ INDEPENDENT SERVICES INC.

Practice address

40 Memorial Hwy Apt 14H
New Rochelle, NY 10801-8326

Phone

(917) 504-7948

NPI assigned

Oct 3, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Loretta Frances Jackson, MSED

Title

President

Phone

(917) 594-7948

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1922518125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MEMORIAL HWY APT 14H",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108018326",
            "telephone_number": "917-504-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MEMORIAL HWY APT 14H",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108018326",
            "telephone_number": "917-504-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LJ INDEPENDENT SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-594-7948",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSED"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "109522413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518229707",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in New Rochelle, NY
• Providers in New Rochelle, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.