Provider Demographics
NPI:1720232341
Name:LIPTON, TALIA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TALIA
Middle Name:
Last Name:LIPTON
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 1:9 DIAMOND COURT
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:NY
Mailing Address - Zip Code:10901
Mailing Address - Country:US
Mailing Address - Phone:917-468-7715
Mailing Address - Fax:
Practice Address - Street 1:9 DIAMOND CT
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:NY
Practice Address - Zip Code:10901-3213
Practice Address - Country:US
Practice Address - Phone:917-468-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist