Doctor Name: | GINA-MARIE MORAVCIK |
NPI Number: | 1720233448 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MASLPCCC |
License Number: | 0012868 |
Business Practice Address: | 541 Long Beach Rd Island Park, NY - 115581045 |
Business Phone Number: | 5168409574 |
Business Fax Number: | |
Mailing Address: | 541 Long Beach Rd, ISLAND PARK |
State: | NY |
Postal Code: | 115581045 |
Phone Number: | 5168409574 |
Fax Number: | |
NPI Enumeration Date: | 11/21/2008 |
NPI Last Update Date: | 11/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0012868 |
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 |