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Organization

JORDAN CAMERON MOSES PLAYHOUSE FOR SPEECH AND LANGUAGE, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JACQUELINE VANESSA RAMPERSAD M.S. (SECRETARY)
(516) 581-2098
Entity
Organization

Contact information

Practice address
118 OHIO AVE, LONG BEACH, NY 11561-1130
(516) 581-2098
Mailing address
118 OHIO AVE, LONG BEACH, NY 11561-1130
(516) 581-2098

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
013020-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
235Z00000X
SPEECH-LANGUAGE PATHOLOGY
NY
Enumeration date
04/11/2014
Last updated
04/11/2014
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