Alysson Aghelian
Individual provider Active NPI Speech-Language Pathologist · Great Neck, NY
NPI 1356841373 · NPPES record last updated Feb 16, 2018
Key facts
- NPI
- 1356841373
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 027293 (NY)
- Practice address
- 79 Watermill LN
Great Neck, NY 11021-4234 - Phone
- (516) 749-6662
- NPI assigned
- Feb 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027293 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidscare Speech Therapy, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | 027293 | NY | Yes |
Addresses
Primary practice location
79 Watermill LN
Great Neck, NY 11021-4234
Mailing address
73 Hicks LN
Great Neck, NY 11024-2027
Other names
- Alysson Azra
Other providers in Great Neck, NY
- Troy Agard
- Ageless Mind Ny Inc
- Elham Aghajani
- Natalie Aghajani
- Ariella Aghalarian
- Michelle Lee Agin
- Vishaal Agrawal
- Ana Rheeda Del Mundo Aguilar
- Cera Reodica Aguiling
- Yigal Aharon
All providers in Great Neck, 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 Feb 16, 2018. 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.