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Organization
FUNCTIONAL SPEECH PATHOLOGY, P.C.
Active
Organization
FUNCTIONAL SPEECH PATHOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEENA VIJAY BHOPALE MS, CCC-SLP (PRESIDENT)
(917) 747-4108
Entity
Organization
Contact information
Practice address
38 CLOVER LN, LEVITTOWN, NY 11756-3304
(917) 747-4108
Mailing address
38 CLOVER LN, LEVITTOWN, NY 11756-3304
(917) 747-4108
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03933075
—
NY
Enumeration date
10/22/2018
Last updated
10/22/2018
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