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General NPI Number Information
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NPI Number | 1073860813
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Entity Type | Organization
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Legal Business Name | BRIDGES TO TOMORROW, SPEECH LANGUAGE PATHOLOGY, PLLC
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Dates
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Enumeration Date | 08/10/2012
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 88 TERRY RD
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City | SMITHTOWN
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State | NY
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Zip | 11787-3811
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Country | US
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Telephone | 631-525-7514
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Fax |
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Provider Business Mailing Address
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Address Line | 88 TERRY RD
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City | SMITHTOWN
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State | NY
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Zip | 11787-3811
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Country | US
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Telephone | 631-525-7514
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | REGINA A GIAMBONE
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Credential | MA/CCC/SLP
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Telephone | 631-525-7514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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