Doctor Name: | MS. MARCIA BLATT |
NPI Number: | 1598192114 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 003678 |
Business Practice Address: | 865 Hawkins Ave Lake Grove, NY - 117553217 |
Business Phone Number: | 6314711800 |
Business Fax Number: | |
Mailing Address: | 51 School Street, LAKE RONKONKOMA |
State: | NY |
Postal Code: | 11779 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/27/2013 |
NPI Last Update Date: | 09/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 003678 |
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 |