Provider Demographics
NPI:1992016190
Name:ALTERBAUM, CARYL BETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARYL
Middle Name:BETH
Last Name:ALTERBAUM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:CARYL
Other - Middle Name:A
Other - Last Name:BRIEF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:205 W END AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4817
Mailing Address - Country:US
Mailing Address - Phone:212-877-8774
Mailing Address - Fax:212-877-8775
Practice Address - Street 1:205 W END AVE APT 3N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4817
Practice Address - Country:US
Practice Address - Phone:212-877-8774
Practice Address - Fax:212-877-8775
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000216-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist