Provider Demographics
NPI:1386108421
Name:SOCIAL ADVENTURES NYC LLC
Entity type:Organization
Organization Name:SOCIAL ADVENTURES NYC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NILI
Authorized Official - Middle Name:
Authorized Official - Last Name:GELDWERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, SLP-CCC
Authorized Official - Phone:917-575-2906
Mailing Address - Street 1:160 W 97TH ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-9233
Mailing Address - Country:US
Mailing Address - Phone:917-575-2906
Mailing Address - Fax:
Practice Address - Street 1:250 E 87TH ST APT 30G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3160
Practice Address - Country:US
Practice Address - Phone:917-575-2906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty