Provider Demographics
NPI:1437302999
Name:O'BRIEN SPEECH, LANGUAGE & LEARNING PLLC
Entity Type:Organization
Organization Name:O'BRIEN SPEECH, LANGUAGE & LEARNING PLLC
Other - Org Name:O'BRIEN SPEECH AND LEARNING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:MCMANUS-O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC
Authorized Official - Phone:631-423-7700
Mailing Address - Street 1:161 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2967
Mailing Address - Country:US
Mailing Address - Phone:631-423-7700
Mailing Address - Fax:631-423-7706
Practice Address - Street 1:161 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2967
Practice Address - Country:US
Practice Address - Phone:631-423-7700
Practice Address - Fax:631-423-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03011-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency