Provider Demographics
NPI:1710553102
Name:PALTINA SPEECH LANGUAGE PATHOLOGY PC
Entity type:Organization
Organization Name:PALTINA SPEECH LANGUAGE PATHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALTINA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:917-922-2393
Mailing Address - Street 1:205 E 63RD ST APT 10G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7424
Mailing Address - Country:US
Mailing Address - Phone:917-922-2393
Mailing Address - Fax:
Practice Address - Street 1:205 E 63RD ST APT 10G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7424
Practice Address - Country:US
Practice Address - Phone:917-922-2393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech