Provider Demographics
NPI:1962710806
Name:GOSZCZYCKI, ASHLEY ANN (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:ANN
Last Name:GOSZCZYCKI
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 1:83 MARLBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4301
Mailing Address - Country:US
Mailing Address - Phone:718-284-3110
Mailing Address - Fax:
Practice Address - Street 1:83 MARLBOROUGH RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4301
Practice Address - Country:US
Practice Address - Phone:718-284-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019149-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist