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General NPI Number Information
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NPI Number | 1194968289
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Entity Type | Organization
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Legal Business Name | EXCALIBER CONSULTING INC.
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 115 SPLIT OAK DR
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City | EAST NORWICH
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State | NY
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Zip | 11732-1146
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Country | US
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Telephone | 516-521-2726
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Fax |
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Provider Business Mailing Address
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Address Line | 115 SPLIT OAK DR
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City | EAST NORWICH
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State | NY
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Zip | 11732-1146
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Country | US
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Telephone | 516-521-2726
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LISA ALVAREZ KIERAN
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Credential | MA, CCC - SLP
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Telephone | 516-521-2726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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