Individual
ALYSE TANKANOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(718) 948-1900
Mailing address
561 10TH AVE APT 24H, NEW YORK, NY 10036-3054
(734) 645-2145
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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