Provider Demographics
NPI:1477759991
Name:MASLAK, KAREN MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:MASLAK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 NEWARK ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2821
Mailing Address - Country:US
Mailing Address - Phone:631-957-8276
Mailing Address - Fax:
Practice Address - Street 1:28 NEWARK ST
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2821
Practice Address - Country:US
Practice Address - Phone:631-957-8276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011592-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist