Provider Demographics
NPI:1316192297
Name:LEVITAN, PEGGY (MA/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:LEVITAN
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:SALTZMAN COMMUNITY SERVICES CTR
Mailing Address - Street 2:131 HOFSTRA UNIVERSITY
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11549-0001
Mailing Address - Country:US
Mailing Address - Phone:516-463-5239
Mailing Address - Fax:
Practice Address - Street 1:SALTZMAN COMMUNITY SERVICES CTR
Practice Address - Street 2:131 HOFSTRA UNIVERSITY
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11549-0001
Practice Address - Country:US
Practice Address - Phone:516-463-5239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001585-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist