Provider Demographics
NPI:1346480506
Name:FLORA, EMILY JILL (MS CCC/SLP)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:JILL
Last Name:FLORA
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:114 RIVERBEND DR
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-4461
Mailing Address - Country:US
Mailing Address - Phone:914-414-5211
Mailing Address - Fax:845-483-5675
Practice Address - Street 1:115 DELAFIELD ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1749
Practice Address - Country:US
Practice Address - Phone:845-431-8800
Practice Address - Fax:845-483-5675
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0183731235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03684764Medicaid