Healthcare Provider Details

I. General information

NPI: 1477910727
Provider Name (Legal Business Name): CLARITY SPEECH AND LANGUAGE THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2016
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ETON PL
PLAINVIEW NY
11803-1206
US

IV. Provider business mailing address

6 ETON PL
PLAINVIEW NY
11803-1206
US

V. Phone/Fax

Practice location:
  • Phone: 347-585-1788
  • Fax:
Mailing address:
  • Phone: 347-585-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number018021
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. YULIYA MUNOZ
Title or Position: DIRECTOR/SPEECH LANGUAGE PATHOLOGIS
Credential: MA, CCC-SLP
Phone: 347-585-1788