Provider Demographics
NPI:1760400196
Name:ROSENBERG, HELENE DEBRA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HELENE
Middle Name:DEBRA
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:HELENE
Other - Middle Name:DEBRA
Other - Last Name:ROSENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:27 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-1940
Mailing Address - Country:US
Mailing Address - Phone:631-907-0903
Mailing Address - Fax:
Practice Address - Street 1:27 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937
Practice Address - Country:US
Practice Address - Phone:631-907-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009572235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist