Healthcare Provider Details

I. General information

NPI: 1922303452
Provider Name (Legal Business Name): LEAH RACHEL CORTESE M.S. CCC-SLP, TSSLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH RACHEL RICHMAN M.S. CCC-SLP, TSSLD

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 MT HOPE RD
MIDDLETOWN NY
10940-7135
US

IV. Provider business mailing address

21 HARDSCRABBLE RD
CHESTER NY
10918-4250
US

V. Phone/Fax

Practice location:
  • Phone: 845-344-2292
  • Fax:
Mailing address:
  • Phone: 201-247-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number020136-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: