Provider Demographics
NPI:1326675182
Name:LORA, ZOBEIDA M (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:ZOBEIDA
Middle Name:M
Last Name:LORA
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:ZOBEIDA
Other - Middle Name:M
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:250 THURMAN MUNSON WAY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4850
Mailing Address - Country:US
Mailing Address - Phone:718-292-4397
Mailing Address - Fax:718-292-4399
Practice Address - Street 1:250 THURMAN MUNSON WAY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-4850
Practice Address - Country:US
Practice Address - Phone:718-292-4397
Practice Address - Fax:718-292-4399
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029585-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist