Provider Demographics
NPI:1275839854
Name:PERAL, LINDSEY ALISON (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ALISON
Last Name:PERAL
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 MIDDLE NECK RD
Mailing Address - Street 2:APT 3H
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1948
Mailing Address - Country:US
Mailing Address - Phone:516-457-3794
Mailing Address - Fax:
Practice Address - Street 1:720 MIDDLE NECK RD
Practice Address - Street 2:APT 3H
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-1948
Practice Address - Country:US
Practice Address - Phone:516-457-3794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020714235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist