Provider Demographics
NPI:1891949962
Name:RUSINAK, ERICA (MA, CCC-SLP/TSHH)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:RUSINAK
Suffix:
Gender:F
Credentials:MA, CCC-SLP/TSHH
Other - Prefix:MRS
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:SOLFARO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP/TSHH
Mailing Address - Street 1:388 TRAVIS AVE
Mailing Address - Street 2:SIDE APARTMENT
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6149
Mailing Address - Country:US
Mailing Address - Phone:917-710-2888
Mailing Address - Fax:718-494-2166
Practice Address - Street 1:388 TRAVIS AVE
Practice Address - Street 2:SIDE APARTMENT
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6149
Practice Address - Country:US
Practice Address - Phone:917-710-2888
Practice Address - Fax:718-494-2166
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-15
Last Update Date:2008-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015327--1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist