Provider Demographics
NPI:1922313782
Name:TOTH, MARTHA YOUNG JOO (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:YOUNG JOO
Last Name:TOTH
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 1:3634 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4419
Mailing Address - Country:US
Mailing Address - Phone:646-239-4285
Mailing Address - Fax:
Practice Address - Street 1:3634 24TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-4419
Practice Address - Country:US
Practice Address - Phone:646-239-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015521-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist