Doctor Name: | MRS. ELISE RUDOLPH |
NPI Number: | 1952611295 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 011284 |
Business Practice Address: | 29 Heritage Dr Apt A New City, NY - 109565314 |
Business Phone Number: | 8453572858 |
Business Fax Number: | |
Mailing Address: | 29 Heritage Dr Apt A, NEW CITY |
State: | NY |
Postal Code: | 109565314 |
Phone Number: | 8453572858 |
Fax Number: | |
NPI Enumeration Date: | 10/20/2010 |
NPI Last Update Date: | 10/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 011284 |
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 |