Provider Demographics
NPI:1083873053
Name:SHLAFMAN, SOFYA (AUD, CCC-A FAAA)
Entity Type:Individual
Prefix:
First Name:SOFYA
Middle Name:
Last Name:SHLAFMAN
Suffix:
Gender:F
Credentials:AUD, CCC-A FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 GARRETSON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2329
Mailing Address - Country:US
Mailing Address - Phone:917-841-2910
Mailing Address - Fax:
Practice Address - Street 1:311 COURTYARD DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4248
Practice Address - Country:US
Practice Address - Phone:908-526-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00103300231H00000X
NY002173-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1083873053Medicaid
NY03727144..Medicaid
NY03727144Medicaid