Provider Demographics
NPI:1346967510
Name:BRADY, SHARON (MS ED MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BRADY
Suffix:
Gender:
Credentials:MS ED MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HALSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3007
Mailing Address - Country:US
Mailing Address - Phone:914-224-1158
Mailing Address - Fax:
Practice Address - Street 1:1075 BROADWAY
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2346
Practice Address - Country:US
Practice Address - Phone:914-769-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist