Most Relevant Information
Provider Data
| NPI Number: | 1003474149 |
| Provider Name: | SAMANTHA KOPPELMAN M.S, CCC- SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 030043 |
Most Important Dates
| Enumeration Date: | 06/04/2019 |
| Last Updated: | 10/11/2021 |
Provider Practice Location
850 BAYCHESTER AVE
BRONX
NY
104751702
Practice Location Phone/Fax
| Phone: | 5163612154 |
| Fax: |
Provider Mailing Location
29 CEDAR ST
SYOSSET
NY
117915216
Provider Mailing Phone/Fax
| Phone: | 5163612154 |
| Fax: |