Restorative Speech and Swallow LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL-005981-L Issued in PA

Legal business name

RESTORATIVE SPEECH AND SWALLOW LLC

Practice address

220 W Evergreen Ave
Unit B-1
Philadelphia, PA 19118-3862

Phone

(215) 360-8012

Fax

(866) 456-4839

NPI assigned

May 14, 2014

Last updated

Oct 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amy P Lustig, PHD, MPH, CCC-SLP

Title

Owner

Phone

(215) 360-8012

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1639580517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W EVERGREEN AVE",
            "address_2": "UNIT B-1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183862",
            "telephone_number": "215-360-8012",
            "fax_number": "866-456-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W EVERGREEN AVE",
            "address_2": "UNIT B-1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183862",
            "telephone_number": "215-360-8012",
            "fax_number": "866-456-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE SPEECH AND SWALLOW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "LUSTIG",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-360-8012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MPH, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL-005981-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.