Provider Demographics
NPI:1750521050
Name:PORTNOY, DEBBIE (CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:PORTNOY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:KRAKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8039 190TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1038
Mailing Address - Country:US
Mailing Address - Phone:718-479-1719
Mailing Address - Fax:
Practice Address - Street 1:649 39TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-3101
Practice Address - Country:US
Practice Address - Phone:718-972-0696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist