Provider Demographics
NPI:1124473673
Name:OSPINA-ALZATE, MARTHA
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:OSPINA-ALZATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9410 64TH RD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3047
Mailing Address - Country:US
Mailing Address - Phone:646-733-7481
Mailing Address - Fax:
Practice Address - Street 1:9410 64TH RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3047
Practice Address - Country:US
Practice Address - Phone:646-733-7481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist