Provider Demographics
NPI:1083925689
Name:MAJESKI, ALLAN (SLP)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:MAJESKI
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BLUERIDGE DRIVE EXTENSION
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704
Mailing Address - Country:US
Mailing Address - Phone:917-225-2142
Mailing Address - Fax:
Practice Address - Street 1:100 BLUERIDGE DRIVE EXTENSION
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704
Practice Address - Country:US
Practice Address - Phone:917-225-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00624400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist