Provider Demographics
NPI:1215541990
Name:SCHWARTZ, AVIVA STEPHANIE (SLP)
Entity Type:Individual
Prefix:
First Name:AVIVA
Middle Name:STEPHANIE
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1316
Mailing Address - Country:US
Mailing Address - Phone:516-492-8028
Mailing Address - Fax:
Practice Address - Street 1:999 CENTRAL AVE STE 308
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1205
Practice Address - Country:US
Practice Address - Phone:516-492-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist