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Organization
JORDANCAMERONMOSESPLAYHOUSE
Active
Organization
JORDANCAMERONMOSESPLAYHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON MOSES PH.D., CCC-SLP (PRESIDENT)
(347) 526-6812
Entity
Organization
Contact information
Practice address
118 OHIO AVE, LONG BEACH, NY 11561-1130
(347) 526-6812
(718) 780-4007
Mailing address
118 OHIO AVE, LONG BEACH, NY 11561-1130
(347) 526-6812
(718) 780-4007
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
001515
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JOR011000
NEW YORK CITY BOARD OF EDUCATION IDENTIFIER
NY
Enumeration date
12/28/2010
Last updated
12/28/2010
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