Provider Demographics
NPI:1447400692
Name:ROCKLAND CHILD DEVELOPMENT SERVICES
Entity type:Organization
Organization Name:ROCKLAND CHILD DEVELOPMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTORIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-357-4733
Mailing Address - Street 1:25 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5468
Mailing Address - Country:US
Mailing Address - Phone:845-357-4733
Mailing Address - Fax:845-357-4112
Practice Address - Street 1:25 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5468
Practice Address - Country:US
Practice Address - Phone:845-357-4733
Practice Address - Fax:845-357-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency