Provider Demographics
NPI:1306717491
Name:VARGAS, CASANDRA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CASANDRA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 E 61ST ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8178
Mailing Address - Country:US
Mailing Address - Phone:707-477-3081
Mailing Address - Fax:
Practice Address - Street 1:144 E 128TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1329
Practice Address - Country:US
Practice Address - Phone:646-422-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty