Healthcare Provider Details

I. General information

NPI: 1780058156
Provider Name (Legal Business Name): ESTHER FOGEL, AUDIOLOGY, SLP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2015
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 BROADWAY
LYNBROOK NY
11563-3243
US

IV. Provider business mailing address

261 BROADWAY
LYNBROOK NY
11563-3243
US

V. Phone/Fax

Practice location:
  • Phone: 516-387-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ESTHER FOGEL
Title or Position: PRESIDENT
Credential: AUD.
Phone: 516-387-4000