Provider Demographics
NPI:1376888768
Name:KLEIN, SHOSHANA (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHOSHANA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:SHOSHANA
Other - Middle Name:
Other - Last Name:KLEIN-HELLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:41 WITZEL CT
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2848
Mailing Address - Country:US
Mailing Address - Phone:845-537-7922
Mailing Address - Fax:
Practice Address - Street 1:41 WITZEL CT
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2848
Practice Address - Country:US
Practice Address - Phone:845-537-7922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2019-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022379-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist