Provider Demographics
NPI:1386898450
Name:SULKOWSKI, HILLORY PETERS (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HILLORY
Middle Name:PETERS
Last Name:SULKOWSKI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:HILLORY
Other - Middle Name:
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:58 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-1726
Mailing Address - Country:US
Mailing Address - Phone:917-703-2010
Mailing Address - Fax:
Practice Address - Street 1:58 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-1726
Practice Address - Country:US
Practice Address - Phone:917-703-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-15
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist