Provider Demographics
NPI:1659652246
Name:SYNERGIC THERAPY, INC
Entity Type:Organization
Organization Name:SYNERGIC THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/SYNERGIC THERAPY, INC
Authorized Official - Prefix:MS
Authorized Official - First Name:ANJLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP, MED
Authorized Official - Phone:408-375-4333
Mailing Address - Street 1:1150 S BASCOM AVE
Mailing Address - Street 2:SUITE 17
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3509
Mailing Address - Country:US
Mailing Address - Phone:408-375-4333
Mailing Address - Fax:
Practice Address - Street 1:1150 S BASCOM AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3509
Practice Address - Country:US
Practice Address - Phone:408-375-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 17336251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services