Provider Demographics
NPI:1447794813
Name:ROKHBERG, VALERIA
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:
Last Name:ROKHBERG
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 1:2323 E 12TH ST APT L6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4276
Mailing Address - Country:US
Mailing Address - Phone:917-589-7343
Mailing Address - Fax:
Practice Address - Street 1:1950 SEDGWICK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-2700
Practice Address - Country:US
Practice Address - Phone:718-583-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025204-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist