Organization
CLARA MAZEPA SLP,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA MAZEPA MA,CCC-SLP,TSHH (PRESIDENT)
(917) 566-5757
Entity
Organization
Contact information
Practice address
236 NATICK ST, STATEN ISLAND, NY 10306-1626
(917) 566-5757
Mailing address
236 NATICK ST, STATEN ISLAND, NY 10306
(917) 566-5757
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
012278
NY
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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