Provider Demographics
NPI:1154005940
Name:COYNE SPEECH AND AUDIOLOGY, PLLC
Entity type:Organization
Organization Name:COYNE SPEECH AND AUDIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS COYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-645-9686
Mailing Address - Street 1:25 VARINNA DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1507
Mailing Address - Country:US
Mailing Address - Phone:585-645-9686
Mailing Address - Fax:
Practice Address - Street 1:25 VARINNA DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1507
Practice Address - Country:US
Practice Address - Phone:585-645-9686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty