Provider Demographics
NPI:1861667289
Name:BASSEMIR, MEGAN B (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:B
Last Name:BASSEMIR
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 FIDDLER LN
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3817
Mailing Address - Country:US
Mailing Address - Phone:516-520-0135
Mailing Address - Fax:
Practice Address - Street 1:3614 FIDDLER LN
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3817
Practice Address - Country:US
Practice Address - Phone:516-520-0135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-26
Last Update Date:2008-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018131-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist