Provider Demographics
NPI:1124226212
Name:MAYO, BRENDA ROBIN (MS)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:ROBIN
Last Name:MAYO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:BRENDA
Other - Middle Name:ROBIN
Other - Last Name:SCHEINMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:102 WASHINGTON BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1730
Mailing Address - Country:US
Mailing Address - Phone:631-864-2423
Mailing Address - Fax:
Practice Address - Street 1:102 WASHINGTON BOULEVARD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-1730
Practice Address - Country:US
Practice Address - Phone:631-864-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist