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General NPI Number Information
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NPI Number | 1730456641
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Entity Type | Organization
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Legal Business Name | BOWEN SPEECH THERAPY, PC
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Dates
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Enumeration Date | 11/20/2011
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Last Update Date | 11/20/2011
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Provider Practice Location Address
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Address Line | 1918 BELLMORE AVE
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City | N BELLMORE
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State | NY
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Zip | 11710-5641
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Country | US
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Telephone | 516-707-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 2616 OAK ST
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City | N BELLMORE
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State | NY
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Zip | 11710-3113
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Country | US
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Telephone | 516-707-4248
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELIZABETH BOWEN
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Credential | CCC/SLP
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Telephone | 516-707-4248
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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 | 010217
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License Number State | NY
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