Provider Demographics
NPI:1437118767
Name:S.E.E.D.S. OF THE WILLISTONS INC.
Entity Type:Organization
Organization Name:S.E.E.D.S. OF THE WILLISTONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEVANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, SLP, CCC
Authorized Official - Phone:516-742-5243
Mailing Address - Street 1:129A HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2305
Mailing Address - Country:US
Mailing Address - Phone:516-742-5243
Mailing Address - Fax:516-742-3536
Practice Address - Street 1:129A HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2305
Practice Address - Country:US
Practice Address - Phone:516-742-5243
Practice Address - Fax:516-742-3536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003625-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP-11159449Medicare UPIN
NYM15641Medicare UPIN
NY2C8839Medicare UPIN
NY=========Medicare UPIN
NYP415113Medicare UPIN
NY0095320Medicare UPIN