Provider Demographics
NPI:1275666208
Name:EMBRY, ERIN R (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:R
Last Name:EMBRY
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 1:360 W 47TH ST
Mailing Address - Street 2:APT. #4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3152
Mailing Address - Country:US
Mailing Address - Phone:212-757-5061
Mailing Address - Fax:212-746-8661
Practice Address - Street 1:525 E 68TH ST FL 16
Practice Address - Street 2:BOX 142
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-0893
Practice Address - Fax:212-746-8661
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14060-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist