| Organization Name: | NORTHEASTERN UNIVERSITY |
| NPI Number: | 1518255462 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAMUEL B. SOLOMON (DIRECTOR OF FINANCE AND TREASURER) |
| Mailing Address: | 30 Leon St 503 Beharkis Health Sciences Center Boston |
| State: | MA US |
| Postal Code: | 021155009 |
| Phone Number: | 6173732492 |
| Fax Number: | 6173738756 |
| NPI Enumeration Date: | 07/13/2011 |
| NPI Last Update Date: | 07/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 4AKD |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| 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 |