Provider Demographics
NPI:1205137544
Name:MISCIOSCIA, ELIZABETH SHAY (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:SHAY
Last Name:MISCIOSCIA
Suffix:
Gender:F
Credentials:CCC-SLP
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Mailing Address - Street 1:21 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5009
Mailing Address - Country:US
Mailing Address - Phone:914-631-5730
Mailing Address - Fax:
Practice Address - Street 1:599 BEDFORD RD
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1215
Practice Address - Country:US
Practice Address - Phone:914-631-6047
Practice Address - Fax:914-631-3280
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004135-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist