| NPI | 1285911560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY CECILIA CONTRERAS Speech Language Pathologist 631-855-2491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 017497) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |