Provider Demographics
NPI:1407360647
Name:BARLOW, ALLEGRA SKY
Entity Type:Individual
Prefix:
First Name:ALLEGRA
Middle Name:SKY
Last Name:BARLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 NEW YORK AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4068
Mailing Address - Country:US
Mailing Address - Phone:845-346-6893
Mailing Address - Fax:
Practice Address - Street 1:641 PRESIDENT ST STE 207
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1186
Practice Address - Country:US
Practice Address - Phone:347-268-5979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1175267171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist