Provider Demographics
NPI:1881909802
Name:LANGERT, AMY BETH (MS,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:LANGERT
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5126
Mailing Address - Country:US
Mailing Address - Phone:516-330-2429
Mailing Address - Fax:
Practice Address - Street 1:6 TERRACE CIR APT 3D
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4122
Practice Address - Country:US
Practice Address - Phone:516-330-2429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY014048OtherNEW YORK STATE