Basic Information
| Provider Information | |||||||||
| NPI: | 1245462563 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALDENWANG | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 124 IRENE ST | ||||||||
| Address2: | |||||||||
| City: | LINDENHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117571203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6315929270 | ||||||||
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| Practice Location | |||||||||
| Address1: | 47 HUMPHREY DR | ||||||||
| Address2: | |||||||||
| City: | SYOSSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117914022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169217171 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2009 | ||||||||
| LastUpdateDate: | 08/20/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 018297-1 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.