Provider Demographics
NPI:1609179647
Name:KRIEGEL, ELLEN S (SLP/CCC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:S
Last Name:KRIEGEL
Suffix:
Gender:F
Credentials:SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 LESTER DR
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-1217
Mailing Address - Country:US
Mailing Address - Phone:845-680-1323
Mailing Address - Fax:
Practice Address - Street 1:140 LESTER DR
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-1217
Practice Address - Country:US
Practice Address - Phone:845-680-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist