Healthcare Provider Details

I. General information

NPI: 1801722699
Provider Name (Legal Business Name): NASSAU SPEECH & LANGUAGE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NORTHERN BLVD STE 185
GREAT NECK NY
11021-5338
US

IV. Provider business mailing address

1000 NORTHERN BLVD STE 185
GREAT NECK NY
11021-5338
US

V. Phone/Fax

Practice location:
  • Phone: 516-852-6587
  • Fax:
Mailing address:
  • Phone: 516-852-6587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DAWN RUDERMAN
Title or Position: OWNER/CEO
Credential: MA CCC-SLP
Phone: 516-852-6587