Provider Demographics
NPI:1114263092
Name:MURNICK SPEECH & LANGUAGE ASSOCIATES
Entity Type:Organization
Organization Name:MURNICK SPEECH & LANGUAGE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-873-4726
Mailing Address - Street 1:237 OLD FARM LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-2046
Mailing Address - Country:US
Mailing Address - Phone:954-863-4726
Mailing Address - Fax:
Practice Address - Street 1:237 OLD FARM LN
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-2046
Practice Address - Country:US
Practice Address - Phone:954-873-4726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003804235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty