Provider Demographics
NPI:1588634612
Name:KUSHNER, ROSLYN (MS, CCC)
Entity Type:Individual
Prefix:MRS
First Name:ROSLYN
Middle Name:
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2946 LEE PL
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5032
Mailing Address - Country:US
Mailing Address - Phone:516-783-6448
Mailing Address - Fax:516-379-5329
Practice Address - Street 1:1745 MERRICK AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2700
Practice Address - Country:US
Practice Address - Phone:516-379-5108
Practice Address - Fax:516-379-5329
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004065-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist