Provider Demographics
NPI:1235427287
Name:MAGUIRE SPEECH AND LANGUAGE SERVICES
Entity Type:Organization
Organization Name:MAGUIRE SPEECH AND LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:917-648-5969
Mailing Address - Street 1:119 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PT
Mailing Address - State:NY
Mailing Address - Zip Code:11697-1805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PT
Practice Address - State:NY
Practice Address - Zip Code:11697-1805
Practice Address - Country:US
Practice Address - Phone:917-648-5969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty