Healthcare Provider Details

I. General information

NPI: 1710890264
Provider Name (Legal Business Name): EMILY FRANCES NUGENT MS SLP CCC TSSLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 PARK AVE STE 4010
WANTAGH NY
11793-3799
US

IV. Provider business mailing address

18 LUCILLE CT
MASSAPEQUA NY
11758-6503
US

V. Phone/Fax

Practice location:
  • Phone: 516-221-3653
  • Fax:
Mailing address:
  • Phone: 516-417-6026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4100094
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: