Provider Demographics
NPI:1003199696
Name:STABILE, AMY B (MS CCC-SLP, TSHH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:B
Last Name:STABILE
Suffix:
Gender:F
Credentials:MS CCC-SLP, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3131
Mailing Address - Country:US
Mailing Address - Phone:516-992-3000
Mailing Address - Fax:
Practice Address - Street 1:2600 REGENT PL
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1200
Practice Address - Country:US
Practice Address - Phone:516-992-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015442235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist