Provider Demographics
NPI:1477860278
Name:ISLAND SPEECH PATHOLOGY SERVICES
Entity Type:Organization
Organization Name:ISLAND SPEECH PATHOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:CANTOR APFEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC
Authorized Official - Phone:516-692-5675
Mailing Address - Street 1:65 HOFSTRA DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1814
Mailing Address - Country:US
Mailing Address - Phone:516-692-5675
Mailing Address - Fax:516-692-8074
Practice Address - Street 1:65 HOFSTRA DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1814
Practice Address - Country:US
Practice Address - Phone:516-692-5675
Practice Address - Fax:516-692-8074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3843-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency