Provider Demographics
NPI:1083925267
Name:BARTISHEVICH, KAREN Y (M ED CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:Y
Last Name:BARTISHEVICH
Suffix:
Gender:F
Credentials:M ED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 WARREN ROAD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1862
Mailing Address - Country:US
Mailing Address - Phone:607-257-1555
Mailing Address - Fax:607-257-2958
Practice Address - Street 1:555 WARREN RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1862
Practice Address - Country:US
Practice Address - Phone:607-257-1555
Practice Address - Fax:607-257-2958
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00577-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist