Provider Demographics
NPI:1053436949
Name:ALTSCHULER, TAMI MICKI (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:MICKI
Last Name:ALTSCHULER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:436 STATE ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1003
Mailing Address - Country:US
Mailing Address - Phone:631-327-9034
Mailing Address - Fax:
Practice Address - Street 1:43 NEW SCOTLAND AVE
Practice Address - Street 2:MC 128
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-8603
Practice Address - Fax:518-262-6896
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015030235Z00000X
MA6833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist