Provider Demographics
NPI:1275769150
Name:BURTON, MALKA LEAH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MALKA
Middle Name:LEAH
Last Name:BURTON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:MALKA
Other - Middle Name:
Other - Last Name:GIBBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1142 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4704
Mailing Address - Country:US
Mailing Address - Phone:718-252-0115
Mailing Address - Fax:
Practice Address - Street 1:1142 E 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4704
Practice Address - Country:US
Practice Address - Phone:718-252-0115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017458-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist