Provider Demographics
NPI:1417271073
Name:FURMANEK, MICHELE (MACCC SLP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:FURMANEK
Suffix:
Gender:F
Credentials:MACCC SLP
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:L
Other - Last Name:GOURLAY FURMANEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA/CCC LSLP
Mailing Address - Street 1:155 FAWN HILL RD
Mailing Address - Street 2:
Mailing Address - City:TUXEDO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:10987-3513
Mailing Address - Country:US
Mailing Address - Phone:914-419-2526
Mailing Address - Fax:
Practice Address - Street 1:70 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4114
Practice Address - Country:US
Practice Address - Phone:845-639-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006574-1235Z00000X
NY006574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist