Doctor Name: | MS. CYNTHIA LYNN CERSOSIM |
NPI Number: | 1023385895 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC/SLP |
License Number: | 017749-1 |
Business Practice Address: | 1415 East Third Ave Mary G. Clarkson Elementary School Bay Shore, NY - 117064221 |
Business Phone Number: | 6319681205 |
Business Fax Number: | 6319682461 |
Mailing Address: | 1415 East Third Ave, Mary G. Clarkson Elementary School BAY SHORE |
State: | NY |
Postal Code: | 117064221 |
Phone Number: | 6319681205 |
Fax Number: | 6319682461 |
NPI Enumeration Date: | 11/22/2011 |
NPI Last Update Date: | 11/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 017749-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |