Provider Demographics
NPI:1619045226
Name:DOYLE, CARMELA CHRISTINE (MA,CCC L-SLP)
Entity Type:Individual
Prefix:
First Name:CARMELA
Middle Name:CHRISTINE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MA,CCC L-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:WURTSBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12790-4906
Mailing Address - Country:US
Mailing Address - Phone:845-888-4078
Mailing Address - Fax:
Practice Address - Street 1:2 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1402
Practice Address - Country:US
Practice Address - Phone:845-294-8806
Practice Address - Fax:845-294-8650
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005577-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10106804OtherCDPHP
NY87757OtherGHI
NYM18411OtherEMPIREBLUECROSSBLUESHIELD