Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Blake Ilysa Rose, MSCCCSLP

Individual provider Speech-Language Pathologist · NPI 1023258613

Blake Ilysa Rose, MSCCCSLP is a Speech-Language Pathologist in New York, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009
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Practice location Address checks out

139 E 35th St 5E
New York, NY 10016-4176 Not confirmed with CMS for 17 years — call before visiting
Phone: (516) 410-8452
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 015114 (NY)

Record details

NPI number1023258613
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCCSLP
Sole proprietorNo
NPI enumeratedFebruary 23, 2009
Last updated in NPPESFebruary 23, 2009

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