=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508685256
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNICATION CITY SPEECH THERAPY PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2024
-----------------------------------------------------
Last Update Date | 10/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2555 ELM CT
-----------------------------------------------------
City | NORTH BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-1209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-780-1884
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2555 ELM CT
-----------------------------------------------------
City | NORTH BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-1209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-780-1884
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | MS. EMILY HANNAH LEVINE
-----------------------------------------------------
Credential | CCC-SLP, TSSLD
-----------------------------------------------------
Telephone | 516-780-1884
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------