Provider Demographics
NPI:1306109145
Name:SADOWSKY, MIRIAM (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:
Last Name:SADOWSKY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15015 79TH AVE APT 3J
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3909
Mailing Address - Country:US
Mailing Address - Phone:224-238-8121
Mailing Address - Fax:
Practice Address - Street 1:1134 E 29TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4629
Practice Address - Country:US
Practice Address - Phone:224-238-8121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021909235Z00000X
IL146010721235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist