Provider Demographics
NPI:1316225790
Name:SZYMCZAK, LORI A (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:A
Last Name:SZYMCZAK
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 1:99 OTTER ST
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-1241
Mailing Address - Country:US
Mailing Address - Phone:716-366-8546
Mailing Address - Fax:
Practice Address - Street 1:620 MARAUDER DR
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2339
Practice Address - Country:US
Practice Address - Phone:716-366-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013097235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1346395720OtherDUNKIRK SCHOOL DISTRICT NATIONAL PROVIDER ID