Provider Demographics
NPI:1013226380
Name:BROOKLYN SLP SERVICES
Entity Type:Organization
Organization Name:BROOKLYN SLP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAHRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DARAMOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:917-292-9002
Mailing Address - Street 1:807 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5913
Mailing Address - Country:US
Mailing Address - Phone:917-292-9002
Mailing Address - Fax:718-928-7404
Practice Address - Street 1:807 E 52ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5913
Practice Address - Country:US
Practice Address - Phone:917-292-9002
Practice Address - Fax:718-928-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011433251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)