Provider Demographics
NPI:1710132436
Name:SCALZO LAFF, SHARON TERESA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:TERESA
Last Name:SCALZO LAFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WHITE BIRCH LN
Mailing Address - Street 2:PO BOX 715
Mailing Address - City:GOLDENS BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10526-0715
Mailing Address - Country:US
Mailing Address - Phone:845-264-0676
Mailing Address - Fax:914-232-1020
Practice Address - Street 1:1 WHITE BIRCH LN
Practice Address - Street 2:
Practice Address - City:GOLDENS BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:10526-0715
Practice Address - Country:US
Practice Address - Phone:845-264-0676
Practice Address - Fax:914-232-1020
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010237-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist