Provider Demographics
NPI:1508998196
Name:BRIGHT START SPEECH PATHOLOGY AND LANGUAGE PC
Entity Type:Organization
Organization Name:BRIGHT START SPEECH PATHOLOGY AND LANGUAGE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AYBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-518-2222
Mailing Address - Street 1:3767 RICHMOND AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3827
Mailing Address - Country:US
Mailing Address - Phone:718-967-0359
Mailing Address - Fax:718-967-0394
Practice Address - Street 1:3767 RICHMOND AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-3827
Practice Address - Country:US
Practice Address - Phone:718-967-0359
Practice Address - Fax:718-967-0394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty