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Organization
ISLAND WIDE SPEECH S.L.P. PLLC
Active
Organization
ISLAND WIDE SPEECH S.L.P. PLLC
Active
Other names
Island Wide Speech
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FARA EILEEN AUGUSTOVER M.A. CCC-SLP (OWNER/SPEECH-LANGUAGE PATHOLOGIST)
(516) 508-2751
Entity
Organization
Contact information
Practice address
2539 MARTIN AVE, BELLMORE, NY 11710-3128
(516) 415-2751
(516) 415-2754
Mailing address
2539 MARTIN AVE, BELLMORE, NY 11710-3128
(516) 508-2751
(516) 415-2754
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019969-1
NEW YORK STATE SPEECH-LANGUAGE HEARING ASSOCIATION
NY
01
—
12118306
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
01
—
1861625501
INDIVIDUAL NPI
—
Enumeration date
11/26/2019
Last updated
11/26/2019
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