Provider Demographics
NPI:1487808549
Name:HEIMAN CHESLER, SAMARA LAUREN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SAMARA
Middle Name:LAUREN
Last Name:HEIMAN CHESLER
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 1:200 E 72ND ST APT 30H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4548
Mailing Address - Country:US
Mailing Address - Phone:516-816-6938
Mailing Address - Fax:
Practice Address - Street 1:200 E 72ND ST APT 30H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4548
Practice Address - Country:US
Practice Address - Phone:516-816-6938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014195-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist