Provider Demographics
NPI:1508219379
Name:A. D. SPEECH & LANGUAGE SERVICES, PLLC
Entity Type:Organization
Organization Name:A. D. SPEECH & LANGUAGE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMOSTHENES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:516-253-4827
Mailing Address - Street 1:130 N KING ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4229
Mailing Address - Country:US
Mailing Address - Phone:516-253-4827
Mailing Address - Fax:516-216-1975
Practice Address - Street 1:130 N KING ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4229
Practice Address - Country:US
Practice Address - Phone:516-253-4827
Practice Address - Fax:516-216-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty