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General NPI Number Information
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NPI Number | 1780966986
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Entity Type | Organization
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Legal Business Name | STILLO SPEECH-LANGUAGE SERVICES P.C.
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 618 W 177TH ST 5D
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City | NEW YORK
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State | NY
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Zip | 10033-7110
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Country | US
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Telephone | 786-382-4729
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Fax |
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Provider Business Mailing Address
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Address Line | 618 W 177TH ST 5D
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City | NEW YORK
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State | NY
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Zip | 10033-7110
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Country | US
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Telephone | 786-382-4729
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | JOELIA DESIREE CASTILLO
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Credential | M.S., CCC-SLP
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Telephone | 786-382-4729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 019113
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 019113
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License Number State | NY
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