Provider Demographics
NPI:1528339223
Name:CUNNINGHAM, CATHERINE NANCY (MA CCC-SLP, TSSLD)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:NANCY
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MA CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:56 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1750
Mailing Address - Country:US
Mailing Address - Phone:516-456-1370
Mailing Address - Fax:
Practice Address - Street 1:345 E 15TH ST
Practice Address - Street 2:OFFICE 319E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4002
Practice Address - Country:US
Practice Address - Phone:516-456-1370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022229-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist