Healthcare Provider Details

I. General information

NPI: 1649604109
Provider Name (Legal Business Name): AUDIOLOGY AND SPEECH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2013
Last Update Date: 10/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 THEODORE FREMD AVE
RYE NY
10580-1573
US

IV. Provider business mailing address

350 THEODORE FREMD AVE
RYE NY
10580-1573
US

V. Phone/Fax

Practice location:
  • Phone: 914-588-8088
  • Fax: 914-470-1433
Mailing address:
  • Phone: 914-588-8088
  • Fax: 914-470-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number653
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7546
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4589
License Number StateCT

VIII. Authorized Official

Name: DR. NANCY L. DATINO
Title or Position: EXECUTIVE DIRECTOR
Credential: AU.D.
Phone: 914-588-8088