1033364542 NPI number — FIRST STEPS SPEECH LANGUAGE PATHOLOGY AND OCCUPATIONAL THERAPY, PLLC

Table of content: (NPI 1033364542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033364542 NPI number — FIRST STEPS SPEECH LANGUAGE PATHOLOGY AND OCCUPATIONAL THERAPY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST STEPS SPEECH LANGUAGE PATHOLOGY AND OCCUPATIONAL THERAPY, PLLC
Provider Last Name:
Provider First Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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NPI Number Information

NPI Number:
1033364542
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
916 THUNDER HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBOURNE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12788-6618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-399-2975
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
916 THUNDER HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODBOURNE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12788-6618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-399-2975
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
LA FORGE
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
JEANNE
Authorized Official Title or Position:
OCCUPATIONAL THERAPIST/ CO-OWNER
Authorized Official Telephone Number:
845-399-2975

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X , with the licence number:  012239-1 , 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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