Provider Demographics
NPI:1447221064
Name:PLATTSBURGH STATE UNIVERSITY SPEECH AND HEARING CENTER
Entity Type:Organization
Organization Name:PLATTSBURGH STATE UNIVERSITY SPEECH AND HEARING CENTER
Other - Org Name:SUNY PLATTSBURGH SPEECH & HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF THE SPEECH CENTER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC SLP
Authorized Official - Phone:518-564-2170
Mailing Address - Street 1:101 BROAD ST
Mailing Address - Street 2:224 SIBLEY HALL
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2637
Mailing Address - Country:US
Mailing Address - Phone:518-564-2170
Mailing Address - Fax:518-564-5110
Practice Address - Street 1:101 BROAD ST
Practice Address - Street 2:224 SIBLEY HALL
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2637
Practice Address - Country:US
Practice Address - Phone:518-564-2170
Practice Address - Fax:518-564-5110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
56950AMedicare ID - Type Unspecified