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General NPI Number Information
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NPI Number | 1326677022
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Entity Type | Individual
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Provider Name | HELAINE BLYE SLP
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Gender | Female
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Dates
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Enumeration Date | 04/04/2020
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Last Update Date | 04/04/2020
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Provider Practice Location Address
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Address Line | 15 PITCHPINE PL
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City | MEDFORD
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State | NY
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Zip | 11763-4208
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Country | US
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Telephone | 800-421-1323
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Fax | 631-569-5718
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Provider Business Mailing Address
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Address Line | 1905 ROUTE 112 UNIT 1304
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City | MEDFORD
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State | NY
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Zip | 11763-6054
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Country | US
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Telephone | 180-421-1323
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Fax | 631-569-5718
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 009539
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License Number State | NY
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