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General NPI Number Information
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NPI Number | 1891003547
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Entity Type | Organization
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Legal Business Name | E. SUFFOLK BOCES
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 51 POTTER ST
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City | PATCHOGUE
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State | NY
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Zip | 11772-4164
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Country | US
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Telephone | 631-447-5992
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Fax |
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Provider Business Mailing Address
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Address Line | 51 POTTER ST
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City | PATCHOGUE
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State | NY
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Zip | 11772-4164
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Country | US
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Telephone | 631-447-5992
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | MRS. JOAN B. ARCHARD
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Credential | LSP, CCC
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Telephone | 631-447-5992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 007243-1
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License Number State | NY
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