Doctor Name: | MS. SANDRA ZELPHA VIDAL |
NPI Number: | 1003056185 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 018896-1 |
Business Practice Address: | 1770 Stillwell Ave Bronx, NY - 104696409 |
Business Phone Number: | 7186529790 |
Business Fax Number: | |
Mailing Address: | 3311 Giles Pl Apt 6f, BRONX |
State: | NY |
Postal Code: | 104634315 |
Phone Number: | 3476027009 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2009 |
NPI Last Update Date: | 03/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 018896-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |