Provider Demographics
NPI:1275041303
Name:HYMOWITZ, SHANNA ALLISON
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:ALLISON
Last Name:HYMOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688A WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5008
Mailing Address - Country:US
Mailing Address - Phone:646-589-0342
Mailing Address - Fax:
Practice Address - Street 1:426 W 58TH ST OFC 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1120
Practice Address - Country:US
Practice Address - Phone:212-604-7155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0026651231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist