Provider Demographics
NPI:1700014669
Name:NEUSCHOTZ, CARMEN KOWALSKI (CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:KOWALSKI
Last Name:NEUSCHOTZ
Suffix:
Gender:F
Credentials:CCC SLP
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Mailing Address - Street 1:1230 AVENUE Y
Mailing Address - Street 2:APT. E21
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4271
Mailing Address - Country:US
Mailing Address - Phone:917-991-6395
Mailing Address - Fax:
Practice Address - Street 1:1230 AVENUE Y
Practice Address - Street 2:APT. E21
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4271
Practice Address - Country:US
Practice Address - Phone:917-991-6395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005085-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist