Basic Information
| Provider Information | |||||||||
| NPI: | 1053531509 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HELEN HAYES HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 507 COUNTRY CLUB LN | ||||||||
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| City: | POMONA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109702345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456411039 | ||||||||
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| Practice Location | |||||||||
| Address1: | 51 S ROUTE 9W # 55 | ||||||||
| Address2: | |||||||||
| City: | WEST HAVERSTRAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109931055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457864000 | ||||||||
| FaxNumber: | 8457864022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PAGANO | ||||||||
| AuthorizedOfficialFirstName: | SARAH | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | SPEECH-LANGUAGE PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8457864267 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | SLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 016495-1 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.