1174812176 NPI number — PROGRESSIVE SPEECH AND LANGUAGE, P.C.

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 1174812176 NPI number — PROGRESSIVE SPEECH AND LANGUAGE, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROGRESSIVE SPEECH AND LANGUAGE, P.C.
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:
1174812176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 WEST END AVENUE, SUITE 1F
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-877-8774
Provider Business Mailing Address Fax Number:
212-877-8775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 WEST END AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1F
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-877-8774
Provider Business Practice Location Address Fax Number:
212-877-8775
Provider Enumeration Date:
03/31/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BRIEF
Authorized Official First Name:
CARYL
Authorized Official Middle Name:
ALTERBAUM
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
212-877-8774

Provider Taxonomy Codes

  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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