Provider Demographics
NPI:1427284819
Name:BOWEN, ULIA LEANORA
Entity type:Individual
Prefix:MRS
First Name:ULIA
Middle Name:LEANORA
Last Name:BOWEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ULIA
Other - Middle Name:LEANORA
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2770 MATTHEWS AVE
Mailing Address - Street 2:#1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8629
Mailing Address - Country:US
Mailing Address - Phone:914-439-2644
Mailing Address - Fax:
Practice Address - Street 1:2770 MATTHEWS AVE
Practice Address - Street 2:#1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8629
Practice Address - Country:US
Practice Address - Phone:914-439-2644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-31
Last Update Date:2009-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235OOOOOX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist