Provider Demographics
NPI:1982832416
Name:ZAMORE, ELLEN R (MA CCC)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:R
Last Name:ZAMORE
Suffix:
Gender:F
Credentials:MA CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W END AVE
Mailing Address - Street 2:APT 21L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5702
Mailing Address - Country:US
Mailing Address - Phone:212-873-5316
Mailing Address - Fax:212-873-5316
Practice Address - Street 1:150 W END AVE
Practice Address - Street 2:APT 21L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5702
Practice Address - Country:US
Practice Address - Phone:212-873-5316
Practice Address - Fax:212-873-5316
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000840-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist