Provider Demographics
NPI:1740515980
Name:RAYKIN, JULIA (SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:RAYKIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:RAYKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5909 LIEBIG AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1609
Mailing Address - Country:US
Mailing Address - Phone:516-361-0723
Mailing Address - Fax:
Practice Address - Street 1:5909 LIEBIG AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-1609
Practice Address - Country:US
Practice Address - Phone:516-361-0723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP6257235Z00000X
NYSLPDOE235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist