Provider Demographics
NPI:1306220066
Name:CITY PRO GROUP INC
Entity type:Organization
Organization Name:CITY PRO GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:917-822-8630
Mailing Address - Street 1:1240 HOBART AVE
Mailing Address - Street 2:UNIT #2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-6138
Mailing Address - Country:US
Mailing Address - Phone:917-822-8630
Mailing Address - Fax:
Practice Address - Street 1:1240 HOBART AVE
Practice Address - Street 2:UNIT #2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-6138
Practice Address - Country:US
Practice Address - Phone:917-822-8630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023698252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency