Provider Demographics
NPI:1861625501
Name:AUGUSTOVER, FARA EILEEN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:FARA
Middle Name:EILEEN
Last Name:AUGUSTOVER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:FARA
Other - Middle Name:
Other - Last Name:DITKOWSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MACCC-SLP
Mailing Address - Street 1:14 HAROLD RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3908
Mailing Address - Country:US
Mailing Address - Phone:516-415-2751
Mailing Address - Fax:516-415-2754
Practice Address - Street 1:14 HAROLD RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3908
Practice Address - Country:US
Practice Address - Phone:516-415-2751
Practice Address - Fax:516-415-2754
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist