| NPI | 1487013116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL DERUVO Owner 917-273-1448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 8751388) |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-02-23 |