Provider Demographics
NPI:1518390517
Name:KAUFMAN-ASSAF, CHAVA (SLP)
Entity Type:Individual
Prefix:
First Name:CHAVA
Middle Name:
Last Name:KAUFMAN-ASSAF
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CHAVA
Other - Middle Name:
Other - Last Name:KAUFMAN-ASSAF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:48 BAKERTOWN RD
Mailing Address - Street 2:402
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-8428
Mailing Address - Country:US
Mailing Address - Phone:845-782-2300
Mailing Address - Fax:845-782-4176
Practice Address - Street 1:1 DINEV CT
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-6449
Practice Address - Country:US
Practice Address - Phone:845-782-7510
Practice Address - Fax:845-782-5849
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0229602355S0801X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant