Healthcare Provider Details

I. General information

NPI: 1306174693
Provider Name (Legal Business Name): CHAYA FINE MA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SANHEDRIA HAMURCHEVET 125/18
JERUSALEM ISRAEL
55416
IL

IV. Provider business mailing address

741 CORNAGA CT
FAR ROCKAWAY NY
11691-5307
US

V. Phone/Fax

Practice location:
  • Phone: 718-705-7311
  • Fax:
Mailing address:
  • Phone: 718-707-7311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number011335-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: