Provider Demographics
NPI:1669929584
Name:MENDEZ, SARAH (MS, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ROCKVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5535
Mailing Address - Country:US
Mailing Address - Phone:347-596-5936
Mailing Address - Fax:
Practice Address - Street 1:28 ROCKVILLE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5535
Practice Address - Country:US
Practice Address - Phone:347-596-5936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY26944-1235Z00000X
252Y00000X
NY390200000X
NY026944-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No252Y00000XAgenciesEarly Intervention Provider Agency
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program