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General NPI Number Information
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NPI Number | 1548312598
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Entity Type | Organization
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Legal Business Name | MT. ST. URSULA SPEECH CENTER
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 2885 MARION AVE
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City | BRONX
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State | NY
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Zip | 10458-3012
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Country | US
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Telephone | 718-584-7679
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Fax | 718-584-7954
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Provider Business Mailing Address
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Address Line | 2885 MARION AVE
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City | BRONX
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State | NY
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Zip | 10458-3012
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Country | US
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Telephone | 718-584-7679
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Fax | 718-584-7954
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. ELAINE FRIEDMAN
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Credential | MS, DDS
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Telephone | 718-584-7679
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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 | 7000229R
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License Number State | NY
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