Provider Demographics
NPI:1225552821
Name:SHUCHAT, ZALMEN
Entity Type:Individual
Prefix:
First Name:ZALMEN
Middle Name:
Last Name:SHUCHAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1418
Mailing Address - Country:US
Mailing Address - Phone:718-778-3682
Mailing Address - Fax:
Practice Address - Street 1:429 W BROADWAY
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1418
Practice Address - Country:US
Practice Address - Phone:718-778-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027845-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY027845-1OtherLICENSE#
NY027845-1OtherNYS LICENSE