Provider Demographics
NPI:1992066146
Name:PLATT, ROBERTA SCHIFF
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:SCHIFF
Last Name:PLATT
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 1:9045 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7823
Mailing Address - Country:US
Mailing Address - Phone:718-849-3002
Mailing Address - Fax:718-264-0838
Practice Address - Street 1:9045 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7823
Practice Address - Country:US
Practice Address - Phone:718-849-3002
Practice Address - Fax:718-264-0838
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001378-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist