Basic Information
| Provider Information | |||||||||
| NPI: | 1124333281 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE GINGERBREAD LEARNING CENTER INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 80 WOODROW RD | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103121313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183560008 | ||||||||
| FaxNumber: | 7183566566 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 WOODROW RD | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103121313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183560008 | ||||||||
| FaxNumber: | 7183566566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2010 | ||||||||
| LastUpdateDate: | 12/07/2010 | ||||||||
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| AuthorizedOfficialLastName: | MOSESMAN | ||||||||
| AuthorizedOfficialFirstName: | DENNIS | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7183560008 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.S., M.S. ED. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251300000X | N | Agencies | Local Education Agency (LEA) | 251B00000X | N | Agencies | Case Management | 252Y00000X | Y | Agencies | Early Intervention Provider Agency |
No ID Information.