Provider Demographics
NPI:1225642945
Name:TURNER, ANDIE N (MA)
Entity Type:Individual
Prefix:
First Name:ANDIE
Middle Name:N
Last Name:TURNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 76TH ST APT 1BW
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-1584
Mailing Address - Country:US
Mailing Address - Phone:631-905-7465
Mailing Address - Fax:
Practice Address - Street 1:3711 35TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11101-1524
Practice Address - Country:US
Practice Address - Phone:718-706-7500
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 Licenses
StateLicense IDTaxonomies
NY1354984191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist