Provider Demographics
NPI:1568214658
Name:FRL SPEECH
Entity Type:Organization
Organization Name:FRL SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:FABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEROY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:917-776-1388
Mailing Address - Street 1:50 REVERE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1907
Mailing Address - Country:US
Mailing Address - Phone:917-776-1388
Mailing Address - Fax:
Practice Address - Street 1:50 REVERE BLVD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1907
Practice Address - Country:US
Practice Address - Phone:917-776-1388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty