Provider Demographics
NPI:1114159464
Name:THE SPEECH LANGUAGE PLACE, SLP, PC
Entity Type:Organization
Organization Name:THE SPEECH LANGUAGE PLACE, SLP, PC
Other - Org Name:THE SPEECH LANGUAGE PLACE, SLP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHACHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:631-751-3838
Mailing Address - Street 1:207 HALLOCK RD STE 6
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3072
Mailing Address - Country:US
Mailing Address - Phone:631-751-3838
Mailing Address - Fax:
Practice Address - Street 1:207 HALLOCK RD
Practice Address - Street 2:SUITE 6
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3033
Practice Address - Country:US
Practice Address - Phone:631-751-3838
Practice Address - Fax:631-751-3767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty