Provider Demographics
NPI:1417190570
Name:HOLBROOK SPEECH SERVICES, INC.
Entity Type:Organization
Organization Name:HOLBROOK SPEECH SERVICES, INC.
Other - Org Name:HOLBROOK SPEECH AND HEARING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:516-681-8961
Mailing Address - Street 1:24 MIDDLE LN
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2236
Mailing Address - Country:US
Mailing Address - Phone:516-681-8961
Mailing Address - Fax:516-681-8961
Practice Address - Street 1:24 MIDDLE LN
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2236
Practice Address - Country:US
Practice Address - Phone:516-681-8961
Practice Address - Fax:516-681-8961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-19
Last Update Date:2009-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1084261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech