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General NPI Number Information
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NPI Number | 1841622933
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Entity Type | Organization
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Legal Business Name | CAROLTALK LLC
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 25611 PEMBROKE AVE
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City | GREAT NECK
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State | NY
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Zip | 11020-1035
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Country | US
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Telephone | 917-273-3272
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Fax |
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Provider Business Mailing Address
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Address Line | 25611 PEMBROKE AVE
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City | GREAT NECK
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State | NY
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Zip | 11020-1035
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Country | US
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Telephone | 917-273-3272
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Fax |
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Authorized Official
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Title or Position | SPEECH AND LANGAUGE PATHOLOGIST
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Name | CAROL ESPINOSA
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Credential | SLP
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Telephone | 917-273-3272
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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 | 015762-1
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License Number State | NY
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