Provider Demographics
NPI:1447683503
Name:STEP 1 SPEECH & LANGUAGE PATHOLOGY, PHYSICAL, OCCUPATIONAL THERAPY, LI
Entity type:Organization
Organization Name:STEP 1 SPEECH & LANGUAGE PATHOLOGY, PHYSICAL, OCCUPATIONAL THERAPY, LI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:PROF
Authorized Official - First Name:SINAI
Authorized Official - Middle Name:
Authorized Official - Last Name:HALBERTAM
Authorized Official - Suffix:
Authorized Official - Credentials:YR YD
Authorized Official - Phone:718-633-5328
Mailing Address - Street 1:1049 38TH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-1012
Mailing Address - Country:US
Mailing Address - Phone:718-633-5328
Mailing Address - Fax:
Practice Address - Street 1:1049 38TH ST
Practice Address - Street 2:SUITE # 305
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1012
Practice Address - Country:US
Practice Address - Phone:718-633-5328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAPPLIED FOR101YM0800X, 152WV0400X, 235Z00000X, 251S00000X
NYAPLLIED FOR133N00000X
NYAPPLLIED FOR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAPPLIED FOROtherALL HEALTH INSURANCE COMPANIES
NYAPPLIED FORMedicaid