Provider Demographics
NPI:1154857266
Name:RAJEEV PUTTASWAMY SPEECH SERVICES, PLLC
Entity Type:Organization
Organization Name:RAJEEV PUTTASWAMY SPEECH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTTASWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:845-645-1253
Mailing Address - Street 1:50 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1802
Mailing Address - Country:US
Mailing Address - Phone:845-645-1253
Mailing Address - Fax:
Practice Address - Street 1:50 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-1802
Practice Address - Country:US
Practice Address - Phone:845-645-1253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty