Provider Demographics
NPI:1326602095
Name:ZIRKEL, ALLISON NICOLE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:NICOLE
Last Name:ZIRKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CASSA LOOP
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2601
Mailing Address - Country:US
Mailing Address - Phone:631-357-4170
Mailing Address - Fax:
Practice Address - Street 1:109 CASSA LOOP
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-2601
Practice Address - Country:US
Practice Address - Phone:631-357-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-27
Last Update Date:2023-08-21
Deactivation Date:2019-10-07
Deactivation Code:
Reactivation Date:2021-01-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist