Provider Demographics
NPI:1053695619
Name:APPLEBAUM, RISA BETH (MS)
Entity type:Individual
Prefix:MRS
First Name:RISA
Middle Name:BETH
Last Name:APPLEBAUM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2073 SHOREHAM WAY
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5028
Mailing Address - Country:US
Mailing Address - Phone:516-476-9691
Mailing Address - Fax:
Practice Address - Street 1:2073 SHOREHAM WAY
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5028
Practice Address - Country:US
Practice Address - Phone:516-476-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1315355235Z00000X
NY022107-1235Z00000X
NY022107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist