Provider Demographics
NPI:1982307146
Name:BERKOFF, ORLY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ORLY
Middle Name:
Last Name:BERKOFF
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 1:109 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-3109
Mailing Address - Country:US
Mailing Address - Phone:203-667-2002
Mailing Address - Fax:
Practice Address - Street 1:132 E PUTNAM AVE STE 14
Practice Address - Street 2:
Practice Address - City:COS COB
Practice Address - State:CT
Practice Address - Zip Code:06807-2753
Practice Address - Country:US
Practice Address - Phone:203-990-3392
Practice Address - Fax:203-990-3393
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist