Provider Demographics
NPI:1154533537
Name:DOLGIN-LIEBERMAN, ELAINE (MA, CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:DOLGIN-LIEBERMAN
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:MRS
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:DOLGIN-SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 MANOR HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2514
Mailing Address - Country:US
Mailing Address - Phone:914-693-3158
Mailing Address - Fax:
Practice Address - Street 1:18 MANOR HOUSE LN
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2514
Practice Address - Country:US
Practice Address - Phone:914-693-3158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004493-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist