Provider Demographics
NPI:1124165014
Name:TEPPERMAN, LINDA S (MA, CCC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:TEPPERMAN
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 COMMACK RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3438
Mailing Address - Country:US
Mailing Address - Phone:631-499-5360
Mailing Address - Fax:631-499-5568
Practice Address - Street 1:145 COMMACK RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3438
Practice Address - Country:US
Practice Address - Phone:631-499-5360
Practice Address - Fax:631-499-5568
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002425-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist