Provider Demographics
NPI:1255519039
Name:ORESTUK, MICHELE A (MS, CCC-SLP, MBA)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:A
Last Name:ORESTUK
Suffix:
Gender:F
Credentials:MS, CCC-SLP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 S PLANK RD
Mailing Address - Street 2:
Mailing Address - City:SLATE HILL
Mailing Address - State:NY
Mailing Address - Zip Code:10973-4101
Mailing Address - Country:US
Mailing Address - Phone:845-697-5011
Mailing Address - Fax:
Practice Address - Street 1:909 S PLANK RD
Practice Address - Street 2:
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-4101
Practice Address - Country:US
Practice Address - Phone:845-697-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist