Provider Demographics
NPI:1144575127
Name:YASOBOOF, MAZAL (CFY- SLP)
Entity Type:Individual
Prefix:MS
First Name:MAZAL
Middle Name:
Last Name:YASOBOOF
Suffix:
Gender:F
Credentials:CFY- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182-21 TUDOR ROAD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA ESTATES
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1509
Mailing Address - Country:US
Mailing Address - Phone:917-981-0999
Mailing Address - Fax:
Practice Address - Street 1:18221 TUDOR RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1509
Practice Address - Country:US
Practice Address - Phone:917-981-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist