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NPI Code Detail

MEDICARE: MRS. LINDSAY MARIE DOMENICK MA CCC-SLP TSSLD

MEDICARE:  MRS. LINDSAY MARIE DOMENICK  MA CCC-SLP TSSLD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist025383NY

General Provider Information

NPI Number : 1689117392
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDSAY MARIE DOMENICK MA CCC-SLP TSSLD
Provider Business Mailing Address
First Line : 10 DOWNING ST APT 4J
Second Line :
City : NEW YORK
State : NY
Zip : 10014-4764
Country : US
Telephone Number : 914-462-1472
Fax Number :
Provider Business Practice Location Address
First Line : 351 W 18TH ST
Second Line : HUDSON HIGH SCHOOL OF LEARNING TECHNOLOGIES
City : NEW YORK
State : NY
Zip : 10011-4402
Country : US
Telephone Number : 914-462-1472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2016
Last Update Date : 11/16/2021

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Directions to “ MRS. LINDSAY MARIE DOMENICK MA CCC-SLP TSSLD” Practice Location

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