Provider Demographics
NPI:1598337040
Name:PANZENBECK, APRIL MARIE (MS, CFY-SLP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:MARIE
Last Name:PANZENBECK
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 ONTARIO AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4029
Mailing Address - Country:US
Mailing Address - Phone:631-741-5938
Mailing Address - Fax:
Practice Address - Street 1:207 HALLOCK RD STE 6
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3072
Practice Address - Country:US
Practice Address - Phone:631-751-3838
Practice Address - Fax:631-751-3767
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028421235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist