Provider Demographics
NPI:1073885802
Name:L.S. SPEECH THERAPY PC
Entity Type:Organization
Organization Name:L.S. SPEECH THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:917-885-4458
Mailing Address - Street 1:2643 E 24TH ST
Mailing Address - Street 2:APT 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2609
Mailing Address - Country:US
Mailing Address - Phone:917-885-4458
Mailing Address - Fax:718-743-7626
Practice Address - Street 1:2643 E 24TH ST
Practice Address - Street 2:APT 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2609
Practice Address - Country:US
Practice Address - Phone:917-885-4458
Practice Address - Fax:718-743-7626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty