Provider Demographics
NPI:1629217757
Name:SHIRA SOLONCHE SPEECH PATHOLOGY SERVICES
Entity Type:Organization
Organization Name:SHIRA SOLONCHE SPEECH PATHOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRA
Authorized Official - Middle Name:AVIVA
Authorized Official - Last Name:SOLONCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MACCC-SLP
Authorized Official - Phone:917-733-3686
Mailing Address - Street 1:200 W 90TH ST
Mailing Address - Street 2:APT 9E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1234
Mailing Address - Country:US
Mailing Address - Phone:917-733-3686
Mailing Address - Fax:
Practice Address - Street 1:200 W 90TH ST
Practice Address - Street 2:APT 9E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1234
Practice Address - Country:US
Practice Address - Phone:917-733-3686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty