National Provider Identifier

Mary Lisa Maslyn, SPEECH LANGUAGE PATH

Mary Lisa Maslyn, SPEECH LANGUAGE PATH is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Newark, NY and a listed phone number of (315) 331-1700.

NPI 1215221130Newark, NYSpeech-Language Pathologist

Profile Overview

NPI
1215221130
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
June 08, 2011
Last Updated
June 08, 2011

Practice Location

  • 703 E. Maple Avenue
  • Newark, NY 14513

Phone: (315) 331-1700

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1215221130
Entity Type
Individual
Last Name
Maslyn
First Name
Mary
Middle Name
Lisa
Name Prefix
Mrs.
Credential
SPEECH LANGUAGE PATH
Provider Other Last Name
Cornwell
Provider Other First Name
Mary
Provider Other Middle Name
Lisa
Provider Other Name Prefix Text
Miss
Provider Other Credential Text
SPEECH LANGUAGE PATH
Provider Other Last Name Type Code
1
Mailing Street Address
703 E. Maple Avenue
Mailing City
Newark
Mailing State
NY
Mailing ZIP Code
14513
Mailing Country
US
Mailing Phone
(315) 331-1700
Practice Street Address
703 E. Maple Avenue
Practice City
Newark
Practice State
NY
Practice ZIP Code
14513
Practice Country
US
Practice Phone
(315) 331-1700
Practice Fax
(315) 331-9233
Enumeration Date
June 08, 2011
Last Updated
June 08, 2011
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)