Provider Demographics
NPI:1083854749
Name:ROSIN, SHAINA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHAINA
Middle Name:
Last Name:ROSIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14905 79TH AVE
Mailing Address - Street 2:APT 328
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3866
Mailing Address - Country:US
Mailing Address - Phone:718-380-8660
Mailing Address - Fax:
Practice Address - Street 1:14905 79TH AVE
Practice Address - Street 2:APT 328
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3866
Practice Address - Country:US
Practice Address - Phone:718-380-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist