Provider Demographics
NPI:1417142811
Name:BESTREICH, ERIN SAMANTHA (MS)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:SAMANTHA
Last Name:BESTREICH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 UNION SQ E
Mailing Address - Street 2:SUITE 2K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3314
Mailing Address - Country:US
Mailing Address - Phone:212-244-8655
Mailing Address - Fax:
Practice Address - Street 1:10 UNION SQ E
Practice Address - Street 2:SUITE 2K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-844-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-09
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL 1476235Z00000X
NY018500-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist