Provider Demographics
NPI:1356596191
Name:HERMAN, MARSHA SARI (LSP)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:SARI
Last Name:HERMAN
Suffix:
Gender:F
Credentials:LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 E PENN ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3725
Mailing Address - Country:US
Mailing Address - Phone:516-897-2570
Mailing Address - Fax:516-432-1292
Practice Address - Street 1:553 E PENN ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3725
Practice Address - Country:US
Practice Address - Phone:516-897-2570
Practice Address - Fax:516-432-1292
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005891-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist