Provider Demographics
NPI:1376686063
Name:ADELPHI UNIVERSITY
Entity Type:Organization
Organization Name:ADELPHI UNIVERSITY
Other - Org Name:HY WEINBERG CENTER FOR COMMUNICATION DISORDERS
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-877-3385
Mailing Address - Street 1:158 CAMBRIDGE AVE RM 103
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4235
Mailing Address - Country:US
Mailing Address - Phone:516-877-4850
Mailing Address - Fax:516-877-4865
Practice Address - Street 1:158 CAMBRIDGE AVE RM 103
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4235
Practice Address - Country:US
Practice Address - Phone:516-877-4850
Practice Address - Fax:516-877-4865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM0W551Medicare PIN