Provider Demographics
NPI:1245475508
Name:RAPKIN-BERGER, ELLEN J (CCC/SLP)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:J
Last Name:RAPKIN-BERGER
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 1:46 LINDBERGH LANE
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3110
Mailing Address - Country:US
Mailing Address - Phone:845-596-5076
Mailing Address - Fax:845-639-4391
Practice Address - Street 1:46 LINDBERGH LANE
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3110
Practice Address - Country:US
Practice Address - Phone:845-596-5076
Practice Address - Fax:845-639-4391
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS 002491-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist