Provider Demographics
NPI:1164494910
Name:STRUM, TATUM ADEIMY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TATUM
Middle Name:ADEIMY
Last Name:STRUM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 SAINT MARKS AVE
Mailing Address - Street 2:FIRST AVENUE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2410
Mailing Address - Country:US
Mailing Address - Phone:212-585-6006
Mailing Address - Fax:212-585-6161
Practice Address - Street 1:340 E 24TH ST
Practice Address - Street 2:ICD
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4019
Practice Address - Country:US
Practice Address - Phone:212-585-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist