Provider Demographics
NPI:1033282314
Name:MERCY COLLEGE SPEECH & HEARING CENTER
Entity Type:Organization
Organization Name:MERCY COLLEGE SPEECH & HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLISSELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-674-7505
Mailing Address - Street 1:555 BROADWAY
Mailing Address - Street 2:MERCY COLLEGE SPEECH AND HEARING CENTER
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522
Mailing Address - Country:US
Mailing Address - Phone:914-674-7742
Mailing Address - Fax:914-674-7597
Practice Address - Street 1:555 BROADWAY
Practice Address - Street 2:MERCY COLLEGE SPEECH AND HEARING CENTER
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522
Practice Address - Country:US
Practice Address - Phone:914-674-7742
Practice Address - Fax:914-674-7597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0002261231H00000X
NY3830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty