Provider Demographics
NPI:1457056681
Name:PAIGE BRIGHAM LLC
Entity Type:Organization
Organization Name:PAIGE BRIGHAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP TSSLD
Authorized Official - Phone:802-917-8333
Mailing Address - Street 1:315 W 98TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5570
Mailing Address - Country:US
Mailing Address - Phone:802-917-8333
Mailing Address - Fax:
Practice Address - Street 1:315 W 98TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5570
Practice Address - Country:US
Practice Address - Phone:802-917-8333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech