Provider Demographics
NPI:1558648956
Name:PEKELIS, RISA
Entity Type:Individual
Prefix:
First Name:RISA
Middle Name:
Last Name:PEKELIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 THERESA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2828
Mailing Address - Country:US
Mailing Address - Phone:516-567-6532
Mailing Address - Fax:
Practice Address - Street 1:629 THERESA AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2828
Practice Address - Country:US
Practice Address - Phone:516-567-6532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist