Provider Demographics
NPI:1962859736
Name:BELLA SPEECH SENSORY WORLD & MORE LLC
Entity Type:Organization
Organization Name:BELLA SPEECH SENSORY WORLD & MORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BURZOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP, TSSLD
Authorized Official - Phone:516-633-4153
Mailing Address - Street 1:3266 RAILROAD AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3711
Mailing Address - Country:US
Mailing Address - Phone:516-663-4153
Mailing Address - Fax:516-785-2303
Practice Address - Street 1:3266 RAILROAD AVE APT B
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3711
Practice Address - Country:US
Practice Address - Phone:516-663-4153
Practice Address - Fax:516-785-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021961-1251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03789700Medicaid