Provider Demographics
NPI:1164634325
Name:LANGUAGE FUNDAMENTALS INC
Entity Type:Organization
Organization Name:LANGUAGE FUNDAMENTALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:845-897-3330
Mailing Address - Street 1:6 LOGANS WAY
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3402
Mailing Address - Country:US
Mailing Address - Phone:845-897-3330
Mailing Address - Fax:
Practice Address - Street 1:6 LOGANS WAY
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3402
Practice Address - Country:US
Practice Address - Phone:845-897-3330
Practice Address - Fax:845-897-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0131891235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400080193Medicare PIN
NYA400082021Medicare PIN
NYA40081359Medicare PIN
NYA400082679Medicare PIN