Healthcare Provider Details

I. General information

NPI: 1952602864
Provider Name (Legal Business Name): REBECCA FRUCHTER ZELKOWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 71ST RD
FLUSHING NY
11367-2001
US

IV. Provider business mailing address

144-45 71ST ROAD
FLUSHING NY
11367
US

V. Phone/Fax

Practice location:
  • Phone: 718-551-5466
  • Fax:
Mailing address:
  • Phone: 718-551-5466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: