Provider Demographics
NPI:1285974469
Name:UNIVERSITY @ BUFFALO SPEECH-LANGUAGE AND HEARING CLINIC
Entity type:Organization
Organization Name:UNIVERSITY @ BUFFALO SPEECH-LANGUAGE AND HEARING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSOR COMMUNICATIVE DISORDERS
Authorized Official - Prefix:PROF
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:LUBINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:716-829-5565
Mailing Address - Street 1:52 BIOMEDICAL EDUCATION BUILDING
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-8016
Mailing Address - Country:US
Mailing Address - Phone:716-829-5565
Mailing Address - Fax:716-829-3979
Practice Address - Street 1:52 BIOMEDICAL EDUCATION BLDG
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-8016
Practice Address - Country:US
Practice Address - Phone:716-829-5565
Practice Address - Fax:716-829-3979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000872235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty