Provider Demographics
NPI:1275734360
Name:LEBOVITZ, ABRAHAM (SLP)
Entity Type:Individual
Prefix:MR
First Name:ABRAHAM
Middle Name:
Last Name:LEBOVITZ
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HEYWARD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-9210
Mailing Address - Country:US
Mailing Address - Phone:718-802-1550
Mailing Address - Fax:718-243-1222
Practice Address - Street 1:18 HEYWARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-9210
Practice Address - Country:US
Practice Address - Phone:718-802-1550
Practice Address - Fax:718-243-1222
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016485-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist