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Organization

LIFESPAN SPEECH AND SWALLOWING SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HOLLY DIRUZZO THOMAS (PRACTICE ADMINISTRATOR)
(315) 552-0406
Entity
Organization

Contact information

Practice address
4820 W TAFT RD STE 202, LIVERPOOL, NY 13088
(315) 552-0406
(315) 634-6230
Mailing address
4820 W TAFT RD STE 202, LIVERPOOL, NY 13088-2806
(315) 552-0406
(315) 634-6230

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06039550
NY
Enumeration date
01/18/2021
Last updated
01/18/2024
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