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General NPI Number Information
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NPI Number | 1912200643
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Entity Type | Organization
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Legal Business Name | RKSLPLLC
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 11111 ROCKAWAY BEACH BLVD
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2354
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Country | US
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Telephone | 917-374-8705
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Fax |
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Provider Business Mailing Address
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Address Line | 1318 DAVIES RD
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-5107
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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 | SPEECH THERAPIST
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Name | RACHEL KAUFMAN
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Credential |
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Telephone | 917-374-8705
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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 | 018593
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License Number State | NY
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