NPI 1619226750

St.Mary's Healthcare System for Children

Organisation Exclusive Provider Organization New Hyde Park, NY

Practice location

Address: 5 Dakota Dr Suite 200, New Hyde Park, NY 11042-1107
Phone: (718) 281-8579

Authorised official

Name: Leah Jane Lavender-Tabar
Title: Speech-Langauge Pathologist
Phone: (917) 670-6781

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 021574 (NY)

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Registry record

NPI: 1619226750
Entity type: Organization
NPI issued: 5 Sep 2012
Record last updated: 5 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.