Theralympic Speech Therapy Pllc | |
622 Hawkins Ave, Ronkonkoma, NY 11779-2374 | |
(631) 240-3579 | |
(631) 979-7444 |
Full Name | Theralympic Speech Therapy Pllc |
---|---|
Type | Facility |
Speciality | Early Intervention Provider Agency |
Location | 622 Hawkins Ave, Ronkonkoma, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730665043 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 025056 (New York) | Secondary |
252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
Provider Name | Christiana Neophytou |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1538561782 PECOS PAC ID: 1759611536 Enrollment ID: I20191004000705 |
Provider Name | Stephanie L Montano |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1417100983 PECOS PAC ID: 4587994363 Enrollment ID: I20191204000825 |
Provider Name | Richard Lance Whalley |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1215556428 PECOS PAC ID: 2961825955 Enrollment ID: I20200709001459 |
Provider Name | Cassidy Comerford |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1306322748 PECOS PAC ID: 7416375027 Enrollment ID: I20200915000265 |
Provider Name | Ashley Rose Waldvogel |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1629550991 PECOS PAC ID: 7416367586 Enrollment ID: I20201030000126 |
Provider Name | Jessica Hanna |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1407258734 PECOS PAC ID: 0446640551 Enrollment ID: I20211203002304 |
Provider Name | Amanda Namendorf |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1073260089 PECOS PAC ID: 8325435621 Enrollment ID: I20220504001814 |
Provider Name | Danielle Williams |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1962040295 PECOS PAC ID: 5092194969 Enrollment ID: I20220623000976 |
Provider Name | Michael A Caputo |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1467043612 PECOS PAC ID: 6709260771 Enrollment ID: I20220825002387 |
Provider Name | Helen Papapostolou |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1629367818 PECOS PAC ID: 7517338890 Enrollment ID: I20230124002831 |
Mailing Address | Practice Location Address |
---|---|
Theralympic Speech Therapy Pllc 622 Hawkins Ave, Ronkonkoma, NY 11779-2374 Ph: (631) 240-3579 | Theralympic Speech Therapy Pllc 622 Hawkins Ave, Ronkonkoma, NY 11779-2374 Ph: (631) 240-3579 |