Provider Demographics
NPI:1508481573
Name:LORIA, STEPHANIE M (MA, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:LORIA
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 172ND ST APT 12A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2307
Mailing Address - Country:US
Mailing Address - Phone:401-578-8633
Mailing Address - Fax:
Practice Address - Street 1:1800 ANDREWS AVE S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5202
Practice Address - Country:US
Practice Address - Phone:718-299-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029627235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist