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General NPI Number Information
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NPI Number | 1720158603
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Entity Type | Individual
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Provider Name | MELISSA ANN POLATSCHEK MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 44 ELM ST SUITE 10
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City | HUNTINGTON
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State | NY
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Zip | 11743-3403
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Country | US
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Telephone | 631-425-0656
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Fax | 631-425-0656
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Provider Business Mailing Address
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Address Line | 363 E OLD COUNTRY RD
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City | HICKSVILLE
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State | NY
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Zip | 11801-4224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 016577
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License Number State | NY
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