Provider Demographics
NPI:1346550027
Name:VERKHOVSKY-MUSACCHIA, YELIZAVETA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:YELIZAVETA
Middle Name:
Last Name:VERKHOVSKY-MUSACCHIA
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 1:235 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3917
Mailing Address - Country:US
Mailing Address - Phone:908-233-0305
Mailing Address - Fax:
Practice Address - Street 1:235 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3917
Practice Address - Country:US
Practice Address - Phone:908-233-0305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019238-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist