Provider Demographics
NPI:1710359625
Name:GLOBAL SPEECH LANGUAGE PATHOLOGY PC
Entity Type:Organization
Organization Name:GLOBAL SPEECH LANGUAGE PATHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:POLISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-327-4681
Mailing Address - Street 1:1979 MARCUS AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1076
Mailing Address - Country:US
Mailing Address - Phone:516-327-4681
Mailing Address - Fax:516-327-4684
Practice Address - Street 1:1979 MARCUS AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1076
Practice Address - Country:US
Practice Address - Phone:516-327-4681
Practice Address - Fax:516-327-4684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty