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General NPI Number Information
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NPI Number | 1609262021
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Entity Type | Organization
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Legal Business Name | BIG APPLE SPEECH THERAPY SLP PLLC
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 9151 115TH ST
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City | RICHMOND HILL
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State | NY
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Zip | 11418-3138
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Country | US
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Telephone | 917-702-6809
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Fax |
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Provider Business Mailing Address
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Address Line | 9151 115TH ST
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City | RICHMOND HILL
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State | NY
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Zip | 11418-3138
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Country | US
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Telephone | 917-702-6809
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SHARENE R LEWIS
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Credential | M.S.,CCC-SLP
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Telephone | 917-702-6809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0117471
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License Number State | NY
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