Provider Demographics
NPI:1740707561
Name:BECK, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566-6935
Mailing Address - Country:US
Mailing Address - Phone:845-219-2903
Mailing Address - Fax:
Practice Address - Street 1:2000 NY ROUTE 302
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:NY
Practice Address - Zip Code:10919
Practice Address - Country:US
Practice Address - Phone:845-744-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist