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Organization

SOUTH EAST CENTER FOR SWALLOWING AND COMMUNICATION DISORDERS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KATHLEEN L FITZGERALD MS CCC-SLP (PRESIDENT)
(508) 991-2332
Entity
Organization

Contact information

Practice address
92 GRAPE ST, UNIT 1, NEW BEDFORD, MA 02740-2143
(508) 991-2332
(508) 991-8437
Mailing address
92 GRAPE ST, UNIT 1, NEW BEDFORD, MA 02740-2143
(508) 991-2332
(508) 991-8437

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0G0068
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS
MA
01
691582
TUFTS HEALTHCARE
MA
05
9737570
MA
01
AA14788
HARVARD PILGRIM HEALTHCARE
MA
Enumeration date
10/02/2007
Last updated
06/21/2018
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