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General NPI Number Information
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NPI Number | 1679149595
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Entity Type | Organization
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Legal Business Name | NATHALIA FONSECA SLP P.C.
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 7716 AUSTIN ST APT 1G
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City | FOREST HILLS
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State | NY
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Zip | 11375-6919
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Country | US
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Telephone | 347-449-9465
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Fax |
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Provider Business Mailing Address
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Address Line | 19 AITKEN AVE
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City | HUDSON
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State | NY
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Zip | 12534-2601
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Country | US
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Telephone | 347-449-9465
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Fax | 347-778-0726
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Authorized Official
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Title or Position | CEO/SPEECH-LANGUAGE PATHOLOGIST
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Name | NATHALIA ANDREA FONSECA
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Credential |
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Telephone | 347-449-9465
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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 |
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License Number State |
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