Provider Demographics
NPI:1932254224
Name:RESNICK, LAUREN STEPHANIE (MSCCC,SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:STEPHANIE
Last Name:RESNICK
Suffix:
Gender:F
Credentials:MSCCC,SLP
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:STEPHANIE
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 OTSEGO PL
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1406
Mailing Address - Country:US
Mailing Address - Phone:516-465-1217
Mailing Address - Fax:516-938-5402
Practice Address - Street 1:2 OTSEGO PL
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1406
Practice Address - Country:US
Practice Address - Phone:516-465-1217
Practice Address - Fax:516-938-5402
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005908235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist