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General NPI Number Information
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NPI Number | 1366726481
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Entity Type | Organization
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Legal Business Name | CORNERSTONE SPEECH & LANGUAGE THERAPY, PC
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 1324 LEXINGTON AVE SUITE 316
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City | NEW YORK
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State | NY
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Zip | 10128-1145
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Country | US
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Telephone | 646-998-4798
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 LEXINGTON AVE SUITE 316
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City | NEW YORK
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State | NY
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Zip | 10128-1145
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Country | US
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Telephone | 646-998-4798
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | AMANDA MOHR
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Credential | MA CCC-SLP
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Telephone | 646-998-4798
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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 | 019394
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License Number State | NY
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