Provider Demographics
NPI:1942455019
Name:LUFT, STEPHANIE LOREN (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LOREN
Last Name:LUFT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1976 NORSHON RD
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4627
Mailing Address - Country:US
Mailing Address - Phone:516-317-9339
Mailing Address - Fax:
Practice Address - Street 1:1983 MARCUS AVE STE E110
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2019
Practice Address - Country:US
Practice Address - Phone:516-497-7641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist