Organization
BLUE HORIZON SPEECH-LANGUAGE PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYN PRESTIGIACOMO MS CCC SLP (PRESIDENT)
(631) 235-6388
Entity
Organization
Contact information
Practice address
402 DONALD BLVD, HOLBROOK, NY 11741-3942
(631) 235-6388
Mailing address
402 DONALD BLVD, HOLBROOK, NY 11741-3942
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025137
NYS
NY
Enumeration date
12/03/2019
Last updated
12/03/2019
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