Provider Demographics
NPI:1457649790
Name:STARKE, CHRISTINE (MS CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:STARKE
Suffix:
Gender:F
Credentials:MS CCC-SLP, TSSLD
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:DEJEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP, TSSLD
Mailing Address - Street 1:1575 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5512
Mailing Address - Country:US
Mailing Address - Phone:718-375-8885
Mailing Address - Fax:718-375-8886
Practice Address - Street 1:1575 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5512
Practice Address - Country:US
Practice Address - Phone:718-375-8885
Practice Address - Fax:718-375-8886
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist