Provider Demographics
NPI:1831331065
Name:ATLAS, ZEHAVA (MA)
Entity type:Individual
Prefix:
First Name:ZEHAVA
Middle Name:
Last Name:ATLAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 GRISTMILL LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1813
Mailing Address - Country:US
Mailing Address - Phone:516-902-5149
Mailing Address - Fax:
Practice Address - Street 1:70 GRISTMILL LN
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1813
Practice Address - Country:US
Practice Address - Phone:516-902-5149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12152410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist