Organization
ALTAGRACIA JORGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALTAGRACIA JORGE SPEECH PATHOLOGIST (SPEECH PATHOLOGIST)
(914) 562-6918
Entity
Organization
Contact information
Practice address
258 SOMMERVILLE PL, YONKERS, NY 10703-2211
(914) 562-6918
(914) 207-8299
Mailing address
258 SOMMERVILLE PL, YONKERS, NY 10703-2211
(914) 562-6918
(914) 207-8299
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
019815
NY
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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