1346485182 NPI number — BRYNN PHALYN KATZ M.S., SLP,TSSLD

Table of content: BRYNN PHALYN KATZ M.S., SLP,TSSLD (NPI 1346485182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346485182 NPI number — BRYNN PHALYN KATZ M.S., SLP,TSSLD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KATZ
Provider First Name:
BRYNN
Provider Middle Name:
PHALYN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., SLP,TSSLD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346485182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33 ROCK HALL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11559-1940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-225-7485
Provider Business Mailing Address Fax Number:
646-386-7878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9745 QUEENS BLVD
Provider Second Line Business Practice Location Address:
SUITE 900
Provider Business Practice Location Address City Name:
REGO PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11374-2116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-830-9274
Provider Business Practice Location Address Fax Number:
718-830-9276
Provider Enumeration Date:
12/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  017122-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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