Provider Demographics
NPI:1508010935
Name:DREYFUSS, NANCY MATIS (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:MATIS
Last Name:DREYFUSS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E 63RD ST
Mailing Address - Street 2:E7D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7804
Mailing Address - Country:US
Mailing Address - Phone:212-593-4665
Mailing Address - Fax:
Practice Address - Street 1:425 E 63RD ST
Practice Address - Street 2:E7D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7804
Practice Address - Country:US
Practice Address - Phone:212-593-4665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002601-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist