Doctor Name: | ILYSE LEIBOWITZ |
NPI Number: | 1215214812 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 017119-1 |
Business Practice Address: | 2351 Jerusalem Ave North Bellmore, NY - 117101822 |
Business Phone Number: | 5167196070 |
Business Fax Number: | |
Mailing Address: | 3367 Beltagh Ave, WANTAGH |
State: | NY |
Postal Code: | 117932557 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/09/2011 |
NPI Last Update Date: | 11/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 017119-1 |
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 |