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Organization
NORTH SHORE CENTER FOR SPEECH, LANGUAGE & SWALLOWING DISORDERS
Active
Organization
NORTH SHORE CENTER FOR SPEECH, LANGUAGE & SWALLOWING DISORDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA RILEY MATUSIAK MA, CCC/SLP (SPEECH/ LANGUGE PATHOLOGIST OWNER)
(516) 627-3036
Entity
Organization
Contact information
Practice address
585 STEWART AVE, SUITE 310, GARDEN CITY, NY 11530-4783
(516) 627-3036
(516) 627-6741
Mailing address
585 STEWART AVE, SUITE 310, GARDEN CITY, NY 11530-4783
(516) 627-3036
(516) 627-6741
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06885
NY
252Y00000X
Early Intervention Provider Agency
06885
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01949875
—
NY
Enumeration date
02/05/2016
Last updated
02/12/2016
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