Organization
VILLAGE SPEECH AND LANGUAGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH IANNO (SPEECH PATHOLOGIST/OWNER)
(631) 722-1466
Entity
Organization
Contact information
Practice address
62 MAKAMAH BEACH RD, NORTHPORT, NY 11768
(631) 722-1466
Mailing address
62 MAKAMAH BEACH RD, NORTHPORT, NY 11768-1339
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
004105
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03669761
—
NY
Enumeration date
08/22/2017
Last updated
08/22/2017
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