Provider Demographics
NPI:1669884474
Name:PLOTNICK, LAUREN (MS CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PLOTNICK
Suffix:
Gender:F
Credentials:MS CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:FRIEDWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP, TSSLD
Mailing Address - Street 1:1290 SPOFFORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10474
Mailing Address - Country:US
Mailing Address - Phone:516-526-8300
Mailing Address - Fax:
Practice Address - Street 1:1290 SPOFFORD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474
Practice Address - Country:US
Practice Address - Phone:718-589-4312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019375-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist