Risa M. Brachman, M.A. CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Commack, NY
NPI 1104964774 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104964774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 009296-1 (NY)
- Practice address
- 145 Commack Rd
Commack, NY 11725-3438 - Phone
- (631) 499-5360
- NPI assigned
- Feb 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009296-1 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commack Speech and Language | Past | Accepting new patients | |
| Commack Speech & Language Disorders, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 009296-1 | NY | Yes |
Addresses
Primary practice location
145 Commack Rd
Commack, NY 11725-3438
Mailing address
17 Wichard Blvd
Commack, NY 11725-1706
Phone (631) 670-7160
Other providers in Commack, NY
- John A Bottone
- Krista Marie Bowden
- Daniel Boyle
- Jennifer Lauren Boyle
- David Bracero
- Thomas Brando
- Paul M. Brandoff
- Kara Rose Brehm
- Alyssa Marianna Brennan
- Ciera Brennan
All providers in Commack, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.