Provider Demographics
NPI:1497403547
Name:SANDY, MALIKA S
Entity Type:Individual
Prefix:MS
First Name:MALIKA
Middle Name:S
Last Name:SANDY
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 1:25 TUDOR CITY PL APT 508
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6822
Mailing Address - Country:US
Mailing Address - Phone:347-205-2487
Mailing Address - Fax:
Practice Address - Street 1:25 TUDOR CITY PL APT 508
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6822
Practice Address - Country:US
Practice Address - Phone:347-205-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist