Provider Demographics
NPI:1689966699
Name:SZCZUROWSKI, CHARLOTTE MARIA (MA; SLP-CCC)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:MARIA
Last Name:SZCZUROWSKI
Suffix:
Gender:F
Credentials:MA; SLP-CCC
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:MARIA
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA; CCC-SLP
Mailing Address - Street 1:190 W NECK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2439
Mailing Address - Country:US
Mailing Address - Phone:631-921-6739
Mailing Address - Fax:
Practice Address - Street 1:190 W NECK RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2439
Practice Address - Country:US
Practice Address - Phone:631-921-6739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020786-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist