Provider Demographics
NPI:1841578150
Name:KOMOROWSKI, ALISON BANCROFT (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:BANCROFT
Last Name:KOMOROWSKI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:BANCROFT
Other - Last Name:BIANCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:621 ELMONT RD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4028
Mailing Address - Country:US
Mailing Address - Phone:516-616-0671
Mailing Address - Fax:
Practice Address - Street 1:621 ELMONT RD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4028
Practice Address - Country:US
Practice Address - Phone:516-616-0671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020982235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist