Provider Demographics
NPI:1669675179
Name:CHICK, MICHAEL J (MS SLP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:CHICK
Suffix:
Gender:M
Credentials:MS SLP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 BEACON HILL DR APT 1C
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-7021
Mailing Address - Country:US
Mailing Address - Phone:914-703-2595
Mailing Address - Fax:
Practice Address - Street 1:550 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-5506
Practice Address - Country:US
Practice Address - Phone:914-793-6130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003467235Z00000X
NY014368-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1669675179Medicaid