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NPI Code Detail

MEDICARE: SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C.

MEDICARE: SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist016352-1NY
2235Z00000XSpeech-Language Pathologist016296-1NY

General Provider Information

NPI Number : 1568413771
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C.
Provider Business Mailing Address
First Line : 57190 MAIN RD
Second Line : P.O. BOX 1562
City : SOUTHOLD
State : NY
Zip : 11971-4750
Country : US
Telephone Number : 631-765-3620
Fax Number :
Provider Business Practice Location Address
First Line : 57190 MAIN RD
Second Line :
City : SOUTHOLD
State : NY
Zip : 11971-4750
Country : US
Telephone Number : 631-765-3620
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MS. LISA ANN KELLY
Credential : M.S. CCC-SLP
Telephone Number : 631-765-3620
Provider Enumeration Date : 05/12/2006
Last Update Date : 08/22/2020

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Directions to “SPEECH, LANGUAGE & SWALLOWING CONSULTANTS P.C. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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