Provider Demographics
NPI:1851456628
Name:WESTSIDE VOICE & SWALLOWING DISORDERS
Entity type:Organization
Organization Name:WESTSIDE VOICE & SWALLOWING DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH - LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HEMBREE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:212-541-4606
Mailing Address - Street 1:330 W 58TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1827
Mailing Address - Country:US
Mailing Address - Phone:212-541-4606
Mailing Address - Fax:212-262-6343
Practice Address - Street 1:330 W 58TH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1827
Practice Address - Country:US
Practice Address - Phone:212-541-4606
Practice Address - Fax:212-262-6343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007482-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY007482-1OtherLICENCE NUMBER