Provider Demographics
NPI:1871334078
Name:LAUREN RESNICK, MS, CCC, SLP, INC.
Entity type:Organization
Organization Name:LAUREN RESNICK, MS, CCC, SLP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:516-375-7890
Mailing Address - Street 1:2 OTSEGO PL
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1406
Mailing Address - Country:US
Mailing Address - Phone:516-375-7890
Mailing Address - Fax:516-938-5402
Practice Address - Street 1:2 OTSEGO PL
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1406
Practice Address - Country:US
Practice Address - Phone:516-375-7890
Practice Address - Fax:516-938-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty