Provider Demographics
NPI:1730635236
Name:CHIPALOWSKY, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CHIPALOWSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:OUELLETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:560 WHITE PLAINS RD - ENTA
Mailing Address - Street 2:SUITE 615
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-6802
Mailing Address - Country:US
Mailing Address - Phone:914-984-2534
Mailing Address - Fax:914-425-0480
Practice Address - Street 1:1200 WATERS PL
Practice Address - Street 2:SOUTH LOBBY, SUITE 110
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2728
Practice Address - Country:US
Practice Address - Phone:718-508-4230
Practice Address - Fax:718-863-9743
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002569-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002569OtherAUDIOLOGY LICENSE