Provider Demographics
NPI:1023337375
Name:ROOMBERG, HALLEY JAYE
Entity type:Individual
Prefix:MRS
First Name:HALLEY
Middle Name:JAYE
Last Name:ROOMBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 W 73RD ST
Mailing Address - Street 2:APT. 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3138
Mailing Address - Country:US
Mailing Address - Phone:917-472-7256
Mailing Address - Fax:
Practice Address - Street 1:49 W 73RD ST
Practice Address - Street 2:APT. 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3138
Practice Address - Country:US
Practice Address - Phone:917-472-7256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019979-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist