Basic Information
| Provider Information | |||||||||
| NPI: | 1073713830 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZAFRRANN | ||||||||
| FirstName: | CARRIE | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MCNIECE | ||||||||
| OtherFirstName: | CARRIE | ||||||||
| OtherMiddleName: | LYNN | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 94 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BLOOMFIELD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144699338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5856574482 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 131 DRUMLIN COURT | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153327400 | ||||||||
| FaxNumber: | 5859247049 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 06/08/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 06/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 010314-1 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.