Provider Demographics
NPI:1174403745
Name:NERLINE NELSON SPEECH PATHOLOGY PLLC
Entity type:Organization
Organization Name:NERLINE NELSON SPEECH PATHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NERLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:917-345-2411
Mailing Address - Street 1:2918 AVENUE I STE 1155
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2935
Mailing Address - Country:US
Mailing Address - Phone:347-286-1521
Mailing Address - Fax:
Practice Address - Street 1:1280 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7477
Practice Address - Country:US
Practice Address - Phone:347-286-1521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center