Provider Demographics
NPI:1114551850
Name:MCGLEW, ERIN D (SLP-CF)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:D
Last Name:MCGLEW
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BEDFORD AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1181
Mailing Address - Country:US
Mailing Address - Phone:716-579-1661
Mailing Address - Fax:
Practice Address - Street 1:6800 JERICHO TPKE STE 120W
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4445
Practice Address - Country:US
Practice Address - Phone:516-393-5966
Practice Address - Fax:800-783-5909
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000Medicaid