Provider Demographics
NPI:1942975891
Name:RMG THERAPY, LLC.
Entity Type:Organization
Organization Name:RMG THERAPY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINNES
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP TSSLD
Authorized Official - Phone:631-824-3195
Mailing Address - Street 1:775 PARK AVE STE 255
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-7538
Mailing Address - Country:US
Mailing Address - Phone:631-824-3195
Mailing Address - Fax:631-824-7640
Practice Address - Street 1:775 PARK AVE STE 255
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7538
Practice Address - Country:US
Practice Address - Phone:631-824-3195
Practice Address - Fax:631-824-7640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04879434Medicaid