Provider Demographics
NPI:1013153246
Name:SLEPIAN, JULIE ERICA (MA, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ERICA
Last Name:SLEPIAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ERICA
Other - Last Name:FENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP, TSSLD
Mailing Address - Street 1:436 E 88TH ST
Mailing Address - Street 2:2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6617
Mailing Address - Country:US
Mailing Address - Phone:516-978-7718
Mailing Address - Fax:
Practice Address - Street 1:436 E 88TH ST
Practice Address - Street 2:2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6617
Practice Address - Country:US
Practice Address - Phone:516-978-7718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019706-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03732950Medicaid