Provider Demographics
NPI:1528196318
Name:SCHWAB, CHRISTINE (MS, CCC, SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:PRIVITERA
Other - Last Name:SCHWAB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC,SLP
Mailing Address - Street 1:238 NASSAU RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4327
Mailing Address - Country:US
Mailing Address - Phone:631-427-0128
Mailing Address - Fax:631-427-0128
Practice Address - Street 1:238 NASSAU RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4327
Practice Address - Country:US
Practice Address - Phone:631-521-4242
Practice Address - Fax:631-427-0128
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006670-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39068OtherVYTRA HEALTH PLANS