Provider Demographics
NPI:1578800553
Name:LOMAZOW, ALISON GOLDSTEIN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:GOLDSTEIN
Last Name:LOMAZOW
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:9 PUTNAM GRN APT G
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6033
Mailing Address - Country:US
Mailing Address - Phone:914-643-1676
Mailing Address - Fax:
Practice Address - Street 1:1445 E PUTNAM AVE STE 2
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-1377
Practice Address - Country:US
Practice Address - Phone:203-622-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7399235Z00000X
NY023584235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist