Provider Demographics
NPI:1184963191
Name:SITLER, MARY ELIZABETH (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MARY ELIZABETH
Middle Name:
Last Name:SITLER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16015 POWELLS COVE BLVD
Mailing Address - Street 2:C302
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1355
Mailing Address - Country:US
Mailing Address - Phone:347-612-2078
Mailing Address - Fax:
Practice Address - Street 1:52 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1603
Practice Address - Country:US
Practice Address - Phone:718-935-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58020546235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist