Provider Demographics
NPI:1881446714
Name:LAZOURENKO SPEECH SERVICES P.C.
Entity type:Organization
Organization Name:LAZOURENKO SPEECH SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZOURENKO
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:718-696-9531
Mailing Address - Street 1:1245 AVENUE X APT M1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4253
Mailing Address - Country:US
Mailing Address - Phone:718-696-9531
Mailing Address - Fax:
Practice Address - Street 1:1245 AVENUE X APT M1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4253
Practice Address - Country:US
Practice Address - Phone:718-696-9531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech