Provider Demographics
NPI:1568944874
Name:RIBACOFF, LINDSAY ERIN (MS CCC-SLP TSSLD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ERIN
Last Name:RIBACOFF
Suffix:
Gender:F
Credentials:MS CCC-SLP TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17045 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2105
Mailing Address - Country:US
Mailing Address - Phone:718-480-2840
Mailing Address - Fax:
Practice Address - Street 1:17045 84TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-2105
Practice Address - Country:US
Practice Address - Phone:718-480-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028038235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist