Provider Demographics
NPI:1912618505
Name:ACKERMAN, EMILY PAIGE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:PAIGE
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E 33RD ST APT 6E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4653
Mailing Address - Country:US
Mailing Address - Phone:973-248-5056
Mailing Address - Fax:
Practice Address - Street 1:141 E 33RD ST APT 6E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4653
Practice Address - Country:US
Practice Address - Phone:973-248-5056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032355-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist