Provider Demographics
NPI:1902530199
Name:LAUER, AVITAL AHUVA
Entity Type:Individual
Prefix:
First Name:AVITAL
Middle Name:AHUVA
Last Name:LAUER
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 1:14123 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2054
Mailing Address - Country:US
Mailing Address - Phone:516-417-0389
Mailing Address - Fax:
Practice Address - Street 1:500 BI COUNTY BLVD STE 450
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3995
Practice Address - Country:US
Practice Address - Phone:718-264-1640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist