Provider Demographics
NPI:1154468395
Name:POCHTAR, LINDA S (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:POCHTAR
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1926
Mailing Address - Country:US
Mailing Address - Phone:516-933-0963
Mailing Address - Fax:
Practice Address - Street 1:6 PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1926
Practice Address - Country:US
Practice Address - Phone:516-933-0963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3097235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist