Provider Demographics
NPI:1376775304
Name:RABER, MAYA (MS CCC - SLP)
Entity Type:Individual
Prefix:MRS
First Name:MAYA
Middle Name:
Last Name:RABER
Suffix:
Gender:F
Credentials:MS CCC - SLP
Other - Prefix:MRS
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:GERKINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:159 PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2312
Mailing Address - Country:US
Mailing Address - Phone:718-891-8551
Mailing Address - Fax:718-743-1776
Practice Address - Street 1:159 PEMBROKE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2312
Practice Address - Country:US
Practice Address - Phone:718-891-8551
Practice Address - Fax:718-743-1776
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-08
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004740235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist