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General NPI Number Information
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NPI Number | 1487701876
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Entity Type | Organization
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Legal Business Name | LEXINGTON HEARING AND SPEECH CENTER, INC.
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 74-20 25TH AVE.
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11370-1428
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Country | US
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Telephone | 718-350-3171
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Fax | 718-458-1367
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Provider Business Mailing Address
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Address Line | 74-20 25TH AVE.
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11370-1428
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Country | US
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Telephone | 718-350-3171
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Fax | 718-458-1367
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ADELE AGIN
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Credential | LCSW
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Telephone | 718-350-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 7003226R
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License Number State | NY
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