Provider Demographics
NPI:1750612107
Name:BUCHALSKI, CLARE PATRICE (MS)
Entity type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:PATRICE
Last Name:BUCHALSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:CLARE
Other - Middle Name:PATRICE
Other - Last Name:FETHERSTON
Other - Suffix:IX
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:5 WERNER AVE
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1607
Mailing Address - Country:US
Mailing Address - Phone:845-651-4529
Mailing Address - Fax:516-327-4684
Practice Address - Street 1:5 WERNER AVE
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1607
Practice Address - Country:US
Practice Address - Phone:845-651-4529
Practice Address - Fax:516-327-4684
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist