| |
19 Alex Ln, Glen Cove, NY 11542-4105 | |
(917) 434-3262 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Early Intervention Provider Agency |
Location | 19 Alex Ln, Glen Cove, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447721246 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 006730 (New York) | Secondary |
252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
71-62 244 Street, Douglaston, NY 11362 Ph: (917) 434-3262 | 19 Alex Ln, Glen Cove, NY 11542-4105 Ph: (917) 434-3262 |