| NPI | 1619226750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH JANE LAVENDER-TABAR Speech Langauge Pathologist 917-670-6781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 021574) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2012-09-05 |