Darrel P. Ford, MS CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Bayport, NY

NPI 1942582606 · NPPES record last updated Sep 19, 2011

Key facts

NPI
1942582606
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
012003 (NY)
Practice address
391 Middle Rd
Bayport, NY 11705-1911
Phone
(631) 472-0092
NPI assigned
Sep 19, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
012003NYMDVeterinarian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 012003 NY Yes

Addresses

Primary practice location

391 Middle Rd
Bayport, NY 11705-1911

Mailing address

391 Middle Rd
Bayport, NY 11705-1911
Phone (631) 472-0092

Other providers in Bayport, NY

All providers in Bayport, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.