Provider Demographics
NPI:1861743049
Name:CHUMAS, GRIFFIN KATHLEEN (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:GRIFFIN
Middle Name:KATHLEEN
Last Name:CHUMAS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11123 76TH RD APT E6
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6436
Mailing Address - Country:US
Mailing Address - Phone:631-786-1454
Mailing Address - Fax:
Practice Address - Street 1:251 E 77TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-2045
Practice Address - Country:US
Practice Address - Phone:212-288-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022247-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist