Provider Demographics
NPI:1083828065
Name:BLOCK, CHRISTIE (MA, MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MA, 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 1:65 BROADWAY
Mailing Address - Street 2:SUITE 901
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-2503
Mailing Address - Country:US
Mailing Address - Phone:347-677-3619
Mailing Address - Fax:212-514-5102
Practice Address - Street 1:65 BROADWAY
Practice Address - Street 2:SUITE 901
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2503
Practice Address - Country:US
Practice Address - Phone:347-677-3619
Practice Address - Fax:212-514-5102
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014299235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist