# IAK SPEECH THERAPY PC

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

## Provider details

- **NPI number:** 1083981674
- **Authorized official:** MRS. IRENA AVRUTIN-KHOTYLEV MS,CCC-SLP (PRESIDENT)
- **Authorized official phone:** (917) 541-0110

## Contact information

- **Practice address:** 30 KANSAS PL, BROOKLYN, NY 11234-6909
- **Practice address phone:** (917) 541-0110
- **Mailing address:** 30 KANSAS PL, BROOKLYN, NY 11234-6909
- **Mailing address phone:** (917) 541-0110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 014692 | NY | Yes |

## Other

- **Enumeration date:** 11/26/2011
- **Last updated:** 11/26/2011