Provider Demographics
NPI:1629458286
Name:KRIGSMAN, AMANDA (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:KRIGSMAN
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 1:1666 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-4727
Mailing Address - Country:US
Mailing Address - Phone:718-456-7588
Mailing Address - Fax:718-628-0491
Practice Address - Street 1:1666 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-4727
Practice Address - Country:US
Practice Address - Phone:718-456-7588
Practice Address - Fax:718-628-0491
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist