Organization
MANITA SPEECH PATHOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YELENA MANITA SLP(MS, CCC-SLP) (SPEECH LANGUAGE PATHOLOGIST)
(718) 395-0032
Entity
Organization
Contact information
Practice address
3508 FILLMORE AVE, BROOKLYN, NY 11234-4832
(718) 395-0032
Mailing address
3508 FILLMORE AVE, BROOKLYN, NY 11234-4832
(718) 395-0032
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
020522
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134411
—
NY
Enumeration date
01/22/2018
Last updated
01/22/2018
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