Provider Demographics
NPI:1487097663
Name:BLUMLING, ROCHELLE CULLEN
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:CULLEN
Last Name:BLUMLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FOLGER LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5858
Mailing Address - Country:US
Mailing Address - Phone:631-549-2634
Mailing Address - Fax:
Practice Address - Street 1:3 FOLGER LN
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5858
Practice Address - Country:US
Practice Address - Phone:631-549-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002549-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist