Provider Demographics
NPI:1205117181
Name:ANKELES, DEBORAH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:ANKELES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BOWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2808
Mailing Address - Country:US
Mailing Address - Phone:914-934-7930
Mailing Address - Fax:
Practice Address - Street 1:697 KING ST
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-2337
Practice Address - Country:US
Practice Address - Phone:914-934-7995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12129630235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist