Provider Demographics
NPI:1033683503
Name:SPEECH BUNNY, PC
Entity Type:Organization
Organization Name:SPEECH BUNNY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-247-9754
Mailing Address - Street 1:PO BOX 50135
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-0135
Mailing Address - Country:US
Mailing Address - Phone:347-787-2775
Mailing Address - Fax:
Practice Address - Street 1:180 FRANKLIN AVE APT 219
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-2187
Practice Address - Country:US
Practice Address - Phone:347-787-2775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech