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General NPI Number Information
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NPI Number | 1376147439
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Entity Type | Organization
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Legal Business Name | BRAVO SPEECH THERAPY SERVICES P.C.
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Dates
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Enumeration Date | 11/29/2020
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Last Update Date | 11/29/2020
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Provider Practice Location Address
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Address Line | 935 NEWBRIDGE RD
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-1620
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Country | US
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Telephone | 516-303-4403
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Fax |
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Provider Business Mailing Address
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Address Line | 935 NEWBRIDGE RD
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-1620
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Country | US
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Telephone | 516-303-4403
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LEONARDO PENA DELGADO
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Credential | MS, CCC-SLP
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Telephone | 516-303-4403
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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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