Provider Demographics
NPI:1407401516
Name:CHAYA R. WOHLGEMUTH, SLP, P.C.
Entity Type:Organization
Organization Name:CHAYA R. WOHLGEMUTH, SLP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOHLGEMUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-338-2973
Mailing Address - Street 1:1248 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1257 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1928
Practice Address - Country:US
Practice Address - Phone:718-338-2973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty