Provider Demographics
NPI:1053800482
Name:HUBELBANK, EMILY SARA (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:SARA
Last Name:HUBELBANK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W 112TH ST APT 5B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3906
Mailing Address - Country:US
Mailing Address - Phone:917-882-3465
Mailing Address - Fax:
Practice Address - Street 1:1434 LONGFELLOW AVE # 222C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-1604
Practice Address - Country:US
Practice Address - Phone:917-882-3465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027485235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist