Healthcare Provider Details

I. General information

NPI: 1467831636
Provider Name (Legal Business Name): NICOLE SAIFY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 PEARSALL PL
DEER PARK NY
11729-2113
US

IV. Provider business mailing address

97 PEARSALL PL
DEER PARK NY
11729-2113
US

V. Phone/Fax

Practice location:
  • Phone: 347-993-7670
  • Fax:
Mailing address:
  • Phone: 347-993-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number032312
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: