Provider Demographics
NPI:1154574952
Name:COHEN, ALYSSA JAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:JAN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:JAN
Other - Last Name:GOLDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:57 WINTERBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:CROSS RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10518-1311
Mailing Address - Country:US
Mailing Address - Phone:914-924-2704
Mailing Address - Fax:
Practice Address - Street 1:57 WINTERBERRY CIR
Practice Address - Street 2:
Practice Address - City:CROSS RIVER
Practice Address - State:NY
Practice Address - Zip Code:10518-1311
Practice Address - Country:US
Practice Address - Phone:914-924-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003977235Z00000X
NY012028235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist