Basic Information
Provider Information
NPI: 1093083834
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MESLINSKY
FirstName: ERIC
MiddleName: MATTHEW
NamePrefix: MR.
NameSuffix:  
Credential: TSLD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4402 STRATFORD TER
Address2:  
City: HAMBURG
State: NY
PostalCode: 140752010
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 150 STAHL RD
Address2:  
City: GETZVILLE
State: NY
PostalCode: 140681231
CountryCode: US
TelephoneNumber: 7166293400
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/08/2011
LastUpdateDate: 12/08/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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