Organization
ST.MARY'S HEALTHCARE SYSTEM FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH JANE LAVENDER-TABAR M.A., CCC-SLP (SPEECH-LANGAUGE PATHOLOGIST)
(917) 670-6781
Entity
Organization
Contact information
Practice address
5 DAKOTA DR, SUITE 200, NEW HYDE PARK, NY 11042-1107
(718) 281-8579
Mailing address
5 DAKOTA DR, SUITE 200, NEW HYDE PARK, NY 11042-1107
(718) 281-8579
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
021574
NY
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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