Healthcare Provider Details
I. General information
NPI: 1548963259
Provider Name (Legal Business Name): ALENA MAHAS SPEECH LANGUAGE PATHOLOGY P C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2023
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 AMBER LN
OYSTER BAY NY
11771-3115
US
IV. Provider business mailing address
10 AMBER LN
OYSTER BAY NY
11771-3115
US
V. Phone/Fax
- Phone: 347-770-4009
- Fax: 888-634-3483
- Phone: 347-770-4009
- Fax: 888-634-3483
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALENA
MAHAS
Title or Position: FOUNDER OF ALENA MAHAS SLP, PC
Credential: MS CCC-SLP TSSLD
Phone: 718-791-5013