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Organization

EASTERN SUFFOLK SPEECH AND LANGUAGE PATHOLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. THERESA BLANGIFORTI M.S. CCC-SLP (OWNER/DIRECTOR)
(631) 998-0368
Entity
Organization

Contact information

Practice address
4 MONTAUK HWY, WESTHAMPTON, NY 11977-1235
(631) 998-0368
(631) 878-1722
Mailing address
4 MONTAUK HWY, WESTHAMPTON, NY 11977-1235
(631) 998-0368
(631) 878-1722

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
008637-1
NY
252Y00000X
Early Intervention Provider Agency
Primary
008637-1
NY

Other

Enumeration date
05/04/2010
Last updated
08/23/2022
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