Provider Demographics
NPI:1518235662
Name:G. LIVSHITS SPEECH LANGUAGE PATHOLOGY P.C.
Entity Type:Organization
Organization Name:G. LIVSHITS SPEECH LANGUAGE PATHOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVSHITS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:516-312-6205
Mailing Address - Street 1:832 KEENE LN
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2209
Mailing Address - Country:US
Mailing Address - Phone:516-312-6205
Mailing Address - Fax:516-673-9413
Practice Address - Street 1:832 KEENE LN
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2209
Practice Address - Country:US
Practice Address - Phone:516-312-6205
Practice Address - Fax:516-673-9413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty