Provider Demographics
NPI:1770860827
Name:FISHKIND SANTANGELO, HEIDY SHWOM (MA)
Entity Type:Individual
Prefix:MS
First Name:HEIDY
Middle Name:SHWOM
Last Name:FISHKIND SANTANGELO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WANTAGH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756
Mailing Address - Country:US
Mailing Address - Phone:151-652-0217
Mailing Address - Fax:151-673-1384
Practice Address - Street 1:45 WANTAGH AVE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-5302
Practice Address - Country:US
Practice Address - Phone:151-652-0217
Practice Address - Fax:151-673-1384
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006375235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist