Provider Demographics
NPI:1659648525
Name:QUESTAR III
Entity Type:Organization
Organization Name:QUESTAR III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:518-283-1979
Mailing Address - Street 1:6 PERSHING AVE
Mailing Address - Street 2:SUBMEC94@GMAIL.COM
Mailing Address - City:WYNANTSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12198-8165
Mailing Address - Country:US
Mailing Address - Phone:518-283-1979
Mailing Address - Fax:
Practice Address - Street 1:6 PERSHING AVE
Practice Address - Street 2:
Practice Address - City:WYNANTSKILL
Practice Address - State:NY
Practice Address - Zip Code:12198-8165
Practice Address - Country:US
Practice Address - Phone:518-283-1979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012275-1251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services