Provider Demographics
NPI:1003045691
Name:GOLDKRANTZ ROSENRAUCH, SHARONA (MS SLP CCC)
Entity Type:Individual
Prefix:MRS
First Name:SHARONA
Middle Name:
Last Name:GOLDKRANTZ ROSENRAUCH
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:SHARONA
Other - Middle Name:
Other - Last Name:ROSENRAUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:664 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4219
Mailing Address - Country:US
Mailing Address - Phone:718-982-5971
Mailing Address - Fax:
Practice Address - Street 1:664 STEWART AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4219
Practice Address - Country:US
Practice Address - Phone:718-982-5971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12143247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist