| Organization Name: | NEW YORK SPEECH-LANGUAGE PATHOLOGY, PLLC |
| NPI Number: | 1437570009 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANNA MIRIELLO (DIRECTOR/SPEECH-LANGUAGE PATHOLOGIS) |
| Mailing Address: | 2391 Bell Blvd Ste 205 Bayside |
| State: | NY US |
| Postal Code: | 113602019 |
| Phone Number: | 7189436202 |
| Fax Number: | 7189436204 |
| NPI Enumeration Date: | 12/26/2013 |
| NPI Last Update Date: | 12/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |