Provider Demographics
NPI:1235737198
Name:SARDO, LAUREN M (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:SARDO
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 1:77 S FRANKLIN ST APT FR-116
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3778
Mailing Address - Country:US
Mailing Address - Phone:561-629-3243
Mailing Address - Fax:
Practice Address - Street 1:77 S FRANKLIN ST APT FR-116
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3778
Practice Address - Country:US
Practice Address - Phone:561-629-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist