Provider Demographics
NPI:1518934900
Name:NAEGER, ROSE MARIE (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARIE
Last Name:NAEGER
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:BAMBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5305 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1625
Mailing Address - Country:US
Mailing Address - Phone:716-646-3210
Mailing Address - Fax:716-646-6392
Practice Address - Street 1:150 PLEASANT AVE
Practice Address - Street 2:UNION PLEASANT ELEMENTARY SCHOOL
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4828
Practice Address - Country:US
Practice Address - Phone:716-646-3280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0097311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000640165002OtherBCCB
020571380OtherEMPIRE
020571380OtherNORTH AMERICAN PREFERRED