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Antonia Mazaraki
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Astoria, New York
NPI 1811147051

Antonia Mazaraki is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Astoria, NY. Antonia Mazaraki practices in Astoria, NY. The NPI Number for Antonia Mazaraki is 1811147051 and holds a License No. 015049 (New York).

The current practice location address for Antonia Mazaraki is 2328 36Th St, Astoria, NY and can be reached out via phone at 646-662-6583.

Location: 2328 36Th St, Astoria, NY, 11105-2213
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811147051
Provider Name
Antonia Mazaraki
Credential
Provider Entity Type
Individual
Gender
Female
Address
2328 36Th St, Astoria, NY, 11105-2213
Phone Number
646-662-6583
Fax Number
Provider Enumeration Date
09/24/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2328 36Th St
City
Astoria
State
New York
Zip
11105-2213
Phone Number
646-662-6583
Fax Number
person
Provider Business Mailing Address Details
Address
2328 36Th St
City
Astoria
State
New York
Zip
11105-2213
Phone Number
646-662-6583
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
015049 (New York)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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