Healthcare Provider Details

I. General information

NPI: 1437301389
Provider Name (Legal Business Name): ROBYN E FIELDS MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CAPTAIN LAWRENCE DR
SOUTH SALEM NY
10590-1211
US

IV. Provider business mailing address

6 CAPTAIN LAWRENCE DR
SOUTH SALEM NY
10590-1211
US

V. Phone/Fax

Practice location:
  • Phone: 914-763-9387
  • Fax: 914-763-3437
Mailing address:
  • Phone: 914-763-9387
  • Fax: 914-763-3437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6552-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: