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General NPI Number Information
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NPI Number | 1700120029
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Entity Type | Organization
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Legal Business Name | ADVANCED THERAPY SOLUTIONS
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 19 BISCAYNE DR
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City | SELDEN
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State | NY
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Zip | 11784-1001
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Country | US
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Telephone | 516-819-2626
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Fax | 631-846-8156
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Provider Business Mailing Address
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Address Line | 19 BISCAYNE DR
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City | SELDEN
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State | NY
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Zip | 11784-1001
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Country | US
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Telephone | 516-819-2626
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Fax | 631-846-8156
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Authorized Official
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Title or Position | OWNER
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Name | MS. KELLY PALMA
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Credential | MS CCC SLP
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Telephone | 516-819-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 018474
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License Number State | NY
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