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Organization

LONG BEACH SPEECH LANGUAGE PATHOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. D SUSAN GROARK MA (SPEECH-LANGUAGE PATHOLOGIST)
(516) 889-4691
Entity
Organization

Contact information

Practice address
270 SHORE RD., APT. 30, LONG BEACH, NY 11561-4263
(516) 889-4691
Mailing address
270 SHORE RD., APT. 30, LONG BEACH, NY 11561-4263
(516) 889-4691

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
007 378-1
NY
252Y00000X
Early Intervention Provider Agency
Primary
007 378-1
NY

Other

Enumeration date
11/09/2015
Last updated
11/09/2015
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