Provider Demographics
NPI:1083160774
Name:YORKTOWN SPEECH PATHOLOGY SERVICES, PC
Entity Type:Organization
Organization Name:YORKTOWN SPEECH PATHOLOGY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:SALVADOR
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-CLP/TSHH/BE
Authorized Official - Phone:914-299-8619
Mailing Address - Street 1:26 FIRST ST UNIT 8066
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-7505
Mailing Address - Country:US
Mailing Address - Phone:914-299-8619
Mailing Address - Fax:
Practice Address - Street 1:26 FIRST STREET UNIT 8066
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-7505
Practice Address - Country:US
Practice Address - Phone:914-299-8619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009043252Y00000X
NY009043-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency