Denise Eberle

Individual provider Active NPI Speech-Language Pathologist · Rocky Point, NY

NPI 1124174008 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124174008
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
005615-1 (NY)
Practice address
17 Comus Rd
Rocky Point, NY 11778-9541
Phone
(631) 744-3368
Fax
(631) 744-3368
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005615-1NYMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 005615-1 NY Yes

Addresses

Primary practice location

17 Comus Rd
Rocky Point, NY 11778-9541

Mailing address

17 Comus Rd
Rocky Point, NY 11778-9541

Other providers in Rocky Point, NY

All providers in Rocky Point, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.