Provider Demographics
NPI:1245509249
Name:ISA MARRS SLP, P.C
Entity type:Organization
Organization Name:ISA MARRS SLP, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ILISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:914-488-5282
Mailing Address - Street 1:127 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1461
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:127 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1461
Practice Address - Country:US
Practice Address - Phone:914-488-5282
Practice Address - Fax:914-488-5283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)