Healthcare Provider Details

I. General information

NPI: 1942975891
Provider Name (Legal Business Name): RMG THERAPY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 PARK AVE STE 255
HUNTINGTON NY
11743-7538
US

IV. Provider business mailing address

775 PARK AVE STE 255
HUNTINGTON NY
11743-7538
US

V. Phone/Fax

Practice location:
  • Phone: 631-824-3195
  • Fax: 631-824-7640
Mailing address:
  • Phone: 631-824-3195
  • Fax: 631-824-7640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHEAL MCINNES
Title or Position: SPEECH PATHOLOGIST
Credential: M.A. CCC-SLP TSSLD
Phone: 631-824-3195