Iak Speech Therapy PC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

014692 Issued in NY

Legal business name

IAK SPEECH THERAPY PC

Practice address

30 Kansas PL
Brooklyn, NY 11234-6909

Phone

(917) 541-0110

NPI assigned

Nov 26, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Irena Avrutin-Khotylev, MS,CCC-SLP

Title

President

Phone

(917) 541-0110

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322265600000",
    "number": "1083981674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 KANSAS PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346909",
            "telephone_number": "917-541-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 KANSAS PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346909",
            "telephone_number": "917-541-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAK SPEECH THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-26",
        "last_updated": "2011-11-26",
        "status": "A",
        "authorized_official_last_name": "AVRUTIN-KHOTYLEV",
        "authorized_official_first_name": "IRENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-541-0110",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "014692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.