Provider Demographics
NPI:1336555010
Name:KUPFERMAN, ILENE (MS SLP-CCC)
Entity Type:Individual
Prefix:
First Name:ILENE
Middle Name:
Last Name:KUPFERMAN
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2764 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4807
Mailing Address - Country:US
Mailing Address - Phone:917-885-2536
Mailing Address - Fax:
Practice Address - Street 1:695 E 182ND ST
Practice Address - Street 2:PS 51
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1803
Practice Address - Country:US
Practice Address - Phone:718-733-0347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist