Organization
LEGENDARY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA RUBINOV (SLP-CFY)
(718) 506-4310
Entity
Organization
Contact information
Practice address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(718) 948-1900
Mailing address
9840 64TH AVE, APT 6C, REGO PARK, NY 11374-2545
(718) 506-4310
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
07/30/2013
Last updated
09/09/2013
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