Provider Demographics
NPI:1023564473
Name:DITKOFF, ROBYN LEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:LEE
Last Name:DITKOFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PEMBROKE TRL
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1902
Mailing Address - Country:US
Mailing Address - Phone:201-825-4563
Mailing Address - Fax:
Practice Address - Street 1:30 PEMBROKE TRL
Practice Address - Street 2:
Practice Address - City:UPPER SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-1902
Practice Address - Country:US
Practice Address - Phone:201-825-4563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007371-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist