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Organization

PURPLE TABLE S.L.P., PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARYANN ELIZABETH MASSARI MA CCC-SLP/TSHH (SPEECH-LANGUAGE PATHOLOGIST)
(347) 539-6427
Entity
Organization

Contact information

Practice address
16 POST ST, GLEN HEAD, NY 11545-1809
(347) 539-6427
Mailing address
16 POST STREET, GLEN HEAD, NEW YORK 11545
(347) 539-6427

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
013002
NY

Other

Enumeration date
02/22/2012
Last updated
02/22/2012
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