Provider Demographics
NPI:1093431991
Name:CARYN GLUICK MA SLP PLLC
Entity Type:Organization
Organization Name:CARYN GLUICK MA SLP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GLUICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA SLP PLLC
Authorized Official - Phone:631-707-5890
Mailing Address - Street 1:28 N COUNTRY RD STE 101F
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1518
Mailing Address - Country:US
Mailing Address - Phone:631-707-5890
Mailing Address - Fax:631-828-1382
Practice Address - Street 1:28 N COUNTRY RD STE 101F
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-1518
Practice Address - Country:US
Practice Address - Phone:631-707-5890
Practice Address - Fax:631-828-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty