Provider Demographics
NPI:1851410187
Name:DORSEY, SANDY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SANDY
Middle Name:
Last Name:DORSEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 EDGECOMBE AVE APT 53
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4420
Mailing Address - Country:US
Mailing Address - Phone:917-673-9062
Mailing Address - Fax:
Practice Address - Street 1:515 EDGECOMBE AVE APT 53
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4420
Practice Address - Country:US
Practice Address - Phone:917-673-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009074235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist