Provider Demographics
NPI:1962667543
Name:LONDON, JANET (SLP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:LONDON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 FOX LN
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2809
Mailing Address - Country:US
Mailing Address - Phone:631-239-6614
Mailing Address - Fax:631-239-6614
Practice Address - Street 1:191 FOX LN
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2809
Practice Address - Country:US
Practice Address - Phone:631-239-6614
Practice Address - Fax:631-239-6614
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1693235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist