Doctor Name: | MRS. STACEY L BLUMBERG |
NPI Number: | 1205972122 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 010885-1 |
Business Practice Address: | 109 Breeley Blvd Melville, NY - 117475332 |
Business Phone Number: | 5166377648 |
Business Fax Number: | |
Mailing Address: | 109 Breeley Blvd, MELVILLE |
State: | NY |
Postal Code: | 117475332 |
Phone Number: | 5166377648 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 010885-1 |
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 |