Provider Demographics
NPI:1205080801
Name:LEVI SPEECH THERAPY SERVICES
Entity type:Organization
Organization Name:LEVI SPEECH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YAAKOV
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEVI
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCCSLP
Authorized Official - Phone:845-323-8631
Mailing Address - Street 1:106 MCNAMARA RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1406
Mailing Address - Country:US
Mailing Address - Phone:845-323-8631
Mailing Address - Fax:
Practice Address - Street 1:106 MCNAMARA RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1406
Practice Address - Country:US
Practice Address - Phone:845-323-8631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-09
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009513252Y00000X
NY009877252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency