Provider Demographics
NPI:1225277213
Name:BROPHY, EILEEN MARY (SLP/CCC)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:MARY
Last Name:BROPHY
Suffix:
Gender:F
Credentials:SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HARP LN
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-2206
Mailing Address - Country:US
Mailing Address - Phone:631-563-4721
Mailing Address - Fax:
Practice Address - Street 1:55 HARP LN
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-2206
Practice Address - Country:US
Practice Address - Phone:631-563-4721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008502-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist