Provider Demographics
NPI:1588805568
Name:MARC E. GINSBERG PA
Entity Type:Organization
Organization Name:MARC E. GINSBERG PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:GINSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MSLP
Authorized Official - Phone:561-701-1191
Mailing Address - Street 1:22198 CLOCKTOWER WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4640
Mailing Address - Country:US
Mailing Address - Phone:561-883-8863
Mailing Address - Fax:561-218-0485
Practice Address - Street 1:22198 CLOCKTOWER WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-4640
Practice Address - Country:US
Practice Address - Phone:561-883-8863
Practice Address - Fax:561-218-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3884235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty