Healthcare Provider Details

I. General information

NPI: 1386564508
Provider Name (Legal Business Name): SPEDLAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 AVENUE M APT 4B
BROOKLYN NY
11230-5225
US

IV. Provider business mailing address

1215 AVENUE M APT 4B
BROOKLYN NY
11230-5225
US

V. Phone/Fax

Practice location:
  • Phone: 315-664-3789
  • Fax:
Mailing address:
  • Phone: 315-664-3789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: SEDA VANIAN
Title or Position: CEO
Credential: MSED
Phone: 315-664-3789