Provider Demographics
NPI:1922435296
Name:MORGENROTH, NANCY LEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LEE
Last Name:MORGENROTH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 MARINO AVE
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4208
Mailing Address - Country:US
Mailing Address - Phone:516-767-6920
Mailing Address - Fax:
Practice Address - Street 1:18730 GRAND CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5819
Practice Address - Country:US
Practice Address - Phone:718-264-2931
Practice Address - Fax:718-264-1737
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1947235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist