Organization
COMMACK SPEECH AND LANGUAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH D SHAPIRO (DIRECTOR)
(631) 499-5360
Entity
Organization
Contact information
Practice address
4 SUELLEN COURT, ISLIP, NY 11751
(631) 219-5114
Mailing address
145 COMMACK ROAD, COMMACK, NY 11725
(631) 499-5360
(631) 499-5568
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890335243
EMPIRE PLAN
NY
Enumeration date
10/14/2010
Last updated
10/14/2010
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