Provider Demographics
NPI:1225267610
Name:CLASS (CHILDREN'S LANGUAGE AND SPEECH SERVICES), LLC.
Entity Type:Organization
Organization Name:CLASS (CHILDREN'S LANGUAGE AND SPEECH SERVICES), LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:646-201-9457
Mailing Address - Street 1:280 PARK AVE S
Mailing Address - Street 2:18C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6121
Mailing Address - Country:US
Mailing Address - Phone:516-782-8804
Mailing Address - Fax:
Practice Address - Street 1:250 5TH AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6405
Practice Address - Country:US
Practice Address - Phone:646-201-9457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017380-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency