Provider Demographics
NPI:1588280572
Name:ELORRIAGA, KERRI (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:ELORRIAGA
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 1:141 KESWICK DR
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-3507
Mailing Address - Country:US
Mailing Address - Phone:631-358-6456
Mailing Address - Fax:
Practice Address - Street 1:33 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3489
Practice Address - Country:US
Practice Address - Phone:631-444-4191
Practice Address - Fax:631-444-9508
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011091-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist