Provider Demographics
NPI:1114229549
Name:ZWEBACK-SAFRAN, SHERRY IRIS (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:IRIS
Last Name:ZWEBACK-SAFRAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:SHERRY
Other - Middle Name:IRIS
Other - Last Name:ZWEBACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:477 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:11791
Mailing Address - Country:US
Mailing Address - Phone:516-922-0049
Mailing Address - Fax:
Practice Address - Street 1:477 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791
Practice Address - Country:US
Practice Address - Phone:516-922-0049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist