Provider Demographics
NPI:1750790317
Name:DUBIN, ALYSSA
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:DUBIN
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 1:7312 150TH ST
Mailing Address - Street 2:APT 2C
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2909
Mailing Address - Country:US
Mailing Address - Phone:973-879-5941
Mailing Address - Fax:
Practice Address - Street 1:7312 150TH ST
Practice Address - Street 2:APT 2C
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2909
Practice Address - Country:US
Practice Address - Phone:973-879-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist