# RUSSO SPEECH PATHOLOGY SERVICES, INC.

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

## Provider details

- **NPI number:** 1225282692
- **Authorized official:** MRS. ANGELA L RUSSO M.A., CCCSLP (SPEECH/LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (516) 785-2509

## Contact information

- **Practice address:** 3400 MELVIN PL, SEAFORD, NY 11783-2918
- **Practice address phone:** (516) 785-2509
- **Practice address fax:** (516) 785-2509
- **Mailing address:** 3400 MELVIN PL, SEAFORD, NY 11783-2918
- **Mailing address phone:** (516) 785-2509
- **Mailing address fax:** (516) 785-2509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 0098791 | NY | Yes |

## Other

- **Enumeration date:** 11/11/2008
- **Last updated:** 11/11/2008