Provider Demographics
NPI:1639601750
Name:SPEECH AND HEARING SERVICES
Entity Type:Organization
Organization Name:SPEECH AND HEARING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SPEECH PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-866-5237
Mailing Address - Street 1:17 BROOKS AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6202
Mailing Address - Country:US
Mailing Address - Phone:347-866-5237
Mailing Address - Fax:
Practice Address - Street 1:17 BROOKS AVE UNIT1
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:347-866-5237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017708261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech