Provider Demographics
NPI:1659982692
Name:ASPENLEITER, COLLEEN (MS)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:ASPENLEITER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MARGARET DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1314
Mailing Address - Country:US
Mailing Address - Phone:516-306-6524
Mailing Address - Fax:
Practice Address - Street 1:110 MARGARET DR
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1314
Practice Address - Country:US
Practice Address - Phone:516-306-6524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NY235Z00000X
NY031844235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1659982692Medicaid