Provider Demographics
NPI:1205973468
Name:SCALISE, LAUREN AYN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:AYN
Last Name:SCALISE
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:6430 77TH PL
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2212
Mailing Address - Country:US
Mailing Address - Phone:917-690-3874
Mailing Address - Fax:718-416-3171
Practice Address - Street 1:6430 77TH PL
Practice Address - Street 2:3RD FLOOR
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2212
Practice Address - Country:US
Practice Address - Phone:917-690-3874
Practice Address - Fax:718-416-3171
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2008-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY012788235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist