| Doctor Name: | DINA MARIE VISKOVICH |
| NPI Number: | 1023393352 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 018596-1 |
| Business Practice Address: | 500 Bi County Blvd Suite 114 Farmingdale, NY - 117353988 |
| Business Phone Number: | 7182641640 |
| Business Fax Number: | 7184840530 |
| Mailing Address: | 1428 Bell Blvd, BAYSIDE |
| State: | NY |
| Postal Code: | 113601212 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2011 |
| NPI Last Update Date: | 10/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 018596-1 |
| 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 |