Diane Sue Haber, M.A. CCC/SLP P.C.
Individual provider Active NPI Speech-Language Pathologist · Rego Park Queens, NY
NPI 1407162118 · NPPES record last updated Aug 19, 2010
Key facts
- NPI
- 1407162118
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 003000-1 (NY)
- Practice address
- 62-54 97TH Place 9K
Rego Park Queens, NY 11374 - Phone
- (646) 400-3225
- NPI assigned
- Aug 19, 2010
- 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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003000-1 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 003000-1 | NY | Yes |
Addresses
Primary practice location
62-54 97TH Place 9K
Rego Park Queens, NY 11374
Mailing address
62-54 97TH Place 9K
Rego Park Queens, NY 11374
Phone (646) 400-3225
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2010. 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.