Provider Demographics
NPI:1134556046
Name:IZA SPEECH INC.
Entity type:Organization
Organization Name:IZA SPEECH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ISABELITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC,SLP
Authorized Official - Phone:718-877-1468
Mailing Address - Street 1:4 CHELSEA PL
Mailing Address - Street 2:3D
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3267
Mailing Address - Country:US
Mailing Address - Phone:718-877-1468
Mailing Address - Fax:
Practice Address - Street 1:4 CHELSEA PL
Practice Address - Street 2:3D
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3267
Practice Address - Country:US
Practice Address - Phone:718-877-1468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017913251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health