Doctor Name: | ELINA ETIS |
NPI Number: | 1023329273 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 019168 |
Business Practice Address: | 1651 Coney Island Ave Brooklyn, NY - 112305849 |
Business Phone Number: | 7189981415 |
Business Fax Number: | |
Mailing Address: | 6623 Ridge Blvd Apt 1c, BROOKLYN |
State: | NY |
Postal Code: | 112204859 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/22/2010 |
NPI Last Update Date: | 06/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 019168 |
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 |