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General NPI Number Information
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NPI Number | 1700513777
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Entity Type | Organization
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Legal Business Name | INDUSTRIA PRO CORP.
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 61 DAHLIA LN
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City | DEER PARK
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State | NY
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Zip | 11729-5424
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Country | US
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Telephone | 631-601-7934
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Fax |
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Provider Business Mailing Address
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Address Line | 13 GORDON AVE
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City | WESTBURY
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State | NY
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Zip | 11590-4117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SOFIA SANCHEZ
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Credential |
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Telephone | 631-601-7934
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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 |
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License Number State |
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