Provider Demographics
NPI:1700174877
Name:CURCHACK, MICHELLE REBECCA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:REBECCA
Last Name:CURCHACK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W 70TH ST
Mailing Address - Street 2:4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4454
Mailing Address - Country:US
Mailing Address - Phone:516-578-8380
Mailing Address - Fax:
Practice Address - Street 1:5 ARTHUR DR
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-2128
Practice Address - Country:US
Practice Address - Phone:516-578-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020093-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist