Provider Demographics
NPI:1013322817
Name:BLATT, ALEXANDRIA M (SLP CFY)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:M
Last Name:BLATT
Suffix:
Gender:F
Credentials:SLP CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14428 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1710
Mailing Address - Country:US
Mailing Address - Phone:917-238-2152
Mailing Address - Fax:
Practice Address - Street 1:14428 69TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1710
Practice Address - Country:US
Practice Address - Phone:917-238-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist