Healthcare Provider Details

I. General information

NPI: 1164732277
Provider Name (Legal Business Name): BROOKLYN COLLEGE SPEECH AND HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 BEDFORD AVE ROOM 4400 BOYLAN HALL
BROOKLYN NY
11210-2850
US

IV. Provider business mailing address

2900 BEDFORD AVE ROOM 4400 BOYLAN HALL
BROOKLYN NY
11210-2850
US

V. Phone/Fax

Practice location:
  • Phone: 718-951-5186
  • Fax: 718-951-4363
Mailing address:
  • Phone: 718-951-5186
  • Fax: 718-951-4363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNY

VIII. Authorized Official

Name: MRS. SUSAN BOHNE
Title or Position: ASSISTANT CLINICAL DIRECTOR
Credential: MA CCC SLP.
Phone: 718-951-5186