| Doctor Name: | DR. JOEL STARK |
| NPI Number: | 1124266333 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 000537 |
| Business Practice Address: | 6530 Kissena Blvd Queens College - Speech Language Hearing Center Flushing, NY - 113671575 |
| Business Phone Number: | 7189972930 |
| Business Fax Number: | 7189972935 |
| Mailing Address: | 65-30 Kissena Boulevard, Queens College - Speech Language Hearing Center FLUSHING |
| State: | NY |
| Postal Code: | 11367 |
| Phone Number: | 7819972930 |
| Fax Number: | 7189972935 |
| NPI Enumeration Date: | 01/26/2009 |
| NPI Last Update Date: | 01/26/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 000537 |
| 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 |