Heather Marie Boeckeler, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Merrick, NY

NPI 1336374644 · NPPES record last updated Oct 4, 2023

Key facts

NPI
1336374644
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
017484-1 (NY)
Practice address
122 Shoreham Way
Merrick, NY 11566-5029
Phone
(516) 434-1437
NPI assigned
May 16, 2009
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)
Yes
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
017484-1NYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 017484-1 NY Yes

Addresses

Primary practice location

122 Shoreham Way
Merrick, NY 11566-5029

Mailing address

122 Shoreham Way
Merrick, NY 11566-5029
Phone (516) 434-1437

Other providers in Merrick, NY

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

Sources for this page

Verify at the official NPI Registry.