Provider Demographics
NPI:1942517123
Name:SHUKOFSKY, ELIZABETH BRIDGET (MS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BRIDGET
Last Name:SHUKOFSKY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 KINGS HWY
Mailing Address - Street 2:A9
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1670
Mailing Address - Country:US
Mailing Address - Phone:718-338-1729
Mailing Address - Fax:718-338-1411
Practice Address - Street 1:2425 KINGS HWY
Practice Address - Street 2:A9
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1670
Practice Address - Country:US
Practice Address - Phone:718-338-1729
Practice Address - Fax:718-338-1411
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013571-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist