Provider Demographics
NPI:1114291713
Name:LEJUEZ, ANNA (MA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:LEJUEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:PAPAMICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:9801 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1639
Mailing Address - Country:US
Mailing Address - Phone:718-446-4700
Mailing Address - Fax:718-397-7645
Practice Address - Street 1:9801 25TH AVE
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-1639
Practice Address - Country:US
Practice Address - Phone:718-446-4700
Practice Address - Fax:718-397-7645
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist