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General NPI Number Information
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NPI Number | 1134556046
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Entity Type | Organization
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Legal Business Name | IZA SPEECH INC.
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Dates
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Enumeration Date | 10/09/2013
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 4 CHELSEA PL 3D
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City | GREAT NECK
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State | NY
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Zip | 11021-3267
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Country | US
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Telephone | 718-877-1468
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CHELSEA PL 3D
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City | GREAT NECK
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State | NY
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Zip | 11021-3267
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Country | US
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Telephone | 718-877-1468
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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 | ISABELITA NEGRON
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Credential | MS,CCC,SLP
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Telephone | 718-877-1468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 017913
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License Number State | NY
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