Provider Demographics
NPI:1750667861
Name:LEVENSON, TAMARA A (SLP)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:A
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W 85TH ST
Mailing Address - Street 2:#6AB
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3260
Mailing Address - Country:US
Mailing Address - Phone:917-589-0358
Mailing Address - Fax:
Practice Address - Street 1:255 W 85TH ST
Practice Address - Street 2:#6AB
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3260
Practice Address - Country:US
Practice Address - Phone:917-589-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist