1174069165 NPI number — HAPPY TALK SPEECH AND LANGUAGE THERAPY PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174069165 NPI number — HAPPY TALK SPEECH AND LANGUAGE THERAPY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAPPY TALK SPEECH AND LANGUAGE THERAPY PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1174069165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39 W 14TH ST
Provider Second Line Business Mailing Address:
SUITE 505
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10011-7489
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
39 W 14TH ST
Provider Second Line Business Practice Location Address:
SUITE 505
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10011-7489
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-547-2768
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/13/2017

Additional Information

Authorized Official

Authorized Official Last Name:
GOODMAN
Authorized Official First Name:
DANIELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
732-547-2768

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  020495-1 , 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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