Provider Demographics
NPI:1336383447
Name:AIZENSTAIN, ALISON IVY (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:IVY
Last Name:AIZENSTAIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RAMBLING BROOK RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3730
Mailing Address - Country:US
Mailing Address - Phone:917-860-1010
Mailing Address - Fax:
Practice Address - Street 1:320 EAST 65TH STREET
Practice Address - Street 2:SUITE 117
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-249-2588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0145001235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist