Provider Demographics
NPI:1508920190
Name:OKIN, PAULA (MACCC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:OKIN
Suffix:
Gender:F
Credentials:MACCC
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:MODUGNO
Other - Last Name:OKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MACCC
Mailing Address - Street 1:10 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1123
Mailing Address - Country:US
Mailing Address - Phone:516-627-6391
Mailing Address - Fax:516-627-2057
Practice Address - Street 1:10 LAKE DR
Practice Address - Street 2:
Practice Address - City:MANHASSET HILLS
Practice Address - State:NY
Practice Address - Zip Code:11040-1123
Practice Address - Country:US
Practice Address - Phone:516-627-6391
Practice Address - Fax:516-627-2057
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist