Provider Demographics
NPI:1760082473
Name:NUSSENBLATT, CARLI
Entity Type:Individual
Prefix:MS
First Name:CARLI
Middle Name:
Last Name:NUSSENBLATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 DONALD DR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1833
Mailing Address - Country:US
Mailing Address - Phone:914-355-0413
Mailing Address - Fax:
Practice Address - Street 1:47 DONALD DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1833
Practice Address - Country:US
Practice Address - Phone:914-355-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist