Provider Demographics
NPI:1124273503
Name:ROSENBERG, RACHEL (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:KUCZYNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:354 MARLBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1113
Mailing Address - Country:US
Mailing Address - Phone:516-791-6308
Mailing Address - Fax:
Practice Address - Street 1:354 MARLBOROUGH ROAD
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1113
Practice Address - Country:US
Practice Address - Phone:516-791-6308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014077-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist