Provider Demographics
NPI:1265684153
Name:KUEFNER, ELISSA (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ELISSA
Middle Name:
Last Name:KUEFNER
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 1:24 TINTERN LN
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6616
Mailing Address - Country:US
Mailing Address - Phone:516-815-1980
Mailing Address - Fax:
Practice Address - Street 1:24 TINTERN LN
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6616
Practice Address - Country:US
Practice Address - Phone:516-815-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014266-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist