Organization
THE KIDZ LOUNGE RELATED SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FRANGELICA LEO MS. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST/PARTNER)
(718) 848-0875
Entity
Organization
Contact information
Practice address
15801 CROSSBAY BLVD, HOWARD BEACH, NY 11414-3140
(718) 848-0875
(718) 848-0876
Mailing address
15801 CROSSBAY BLVD, HOWARD BEACH, NY 11414-3140
(718) 848-0875
(718) 848-0876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
025077-1
NY
235Z00000X
Speech-Language Pathologist
020061-1
NY
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033422076
—
NY
05
—
1639314578
—
NY
Enumeration date
06/01/2017
Last updated
07/21/2022
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