Provider Demographics
NPI:1629204151
Name:GRAFMAN, MARINA (MA/CCC SLP)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:GRAFMAN
Suffix:
Gender:F
Credentials:MA/CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 AVENUE U APT 3F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6124
Mailing Address - Country:US
Mailing Address - Phone:917-626-0309
Mailing Address - Fax:
Practice Address - Street 1:6910 AVENUE U APT 3F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6124
Practice Address - Country:US
Practice Address - Phone:917-626-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist