Provider Demographics
NPI:1255635769
Name:LISA P ROSENZWEIG MSCCC-SLP
Entity type:Organization
Organization Name:LISA P ROSENZWEIG MSCCC-SLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-993-7242
Mailing Address - Street 1:2827 BELLMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4326
Mailing Address - Country:US
Mailing Address - Phone:516-783-1565
Mailing Address - Fax:516-783-0607
Practice Address - Street 1:2827 BELLMORE AVENUE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-4326
Practice Address - Country:US
Practice Address - Phone:516-783-1565
Practice Address - Fax:516-783-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004988261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech