Provider Demographics
NPI:1659697498
Name:MAKMAN, JUDITH M (MS/SLP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:M
Last Name:MAKMAN
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CRESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804
Mailing Address - Country:US
Mailing Address - Phone:914-588-1913
Mailing Address - Fax:
Practice Address - Street 1:15 CRESTWOOD LN
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804
Practice Address - Country:US
Practice Address - Phone:914-588-1913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005788-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist