Provider Demographics
NPI:1437444544
Name:VAFIAS-VASAKA, MARIA V (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:V
Last Name:VAFIAS-VASAKA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:V
Other - Last Name:VASAKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1 PARK PLACE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596
Mailing Address - Country:US
Mailing Address - Phone:516-435-6283
Mailing Address - Fax:
Practice Address - Street 1:1 PARK PL
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1138
Practice Address - Country:US
Practice Address - Phone:202-369-5245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021005-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist