# PURPLE TABLE S.L.P., PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003189986
- **Authorized official:** MARYANN ELIZABETH MASSARI MA CCC-SLP/TSHH (SPEECH-LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (347) 539-6427

## Contact information

- **Practice address:** 16 POST ST, GLEN HEAD, NY 11545-1809
- **Practice address phone:** (347) 539-6427
- **Mailing address:** 16 POST STREET, GLEN HEAD, NEW YORK 11545
- **Mailing address phone:** (347) 539-6427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 013002 | NY | Yes |

## Other

- **Enumeration date:** 02/22/2012
- **Last updated:** 02/22/2012