Provider Demographics
NPI:1912276908
Name:LUTZ STEINER, DAWN (SLP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:LUTZ STEINER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4639
Mailing Address - Country:US
Mailing Address - Phone:516-541-0788
Mailing Address - Fax:
Practice Address - Street 1:880 JACKSON ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4837
Practice Address - Country:US
Practice Address - Phone:516-377-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007200-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist