Provider Demographics
NPI:1083997050
Name:CHANDY, DALIA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DALIA
Middle Name:
Last Name:CHANDY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1834
Mailing Address - Country:US
Mailing Address - Phone:347-463-1724
Mailing Address - Fax:
Practice Address - Street 1:285 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1906
Practice Address - Country:US
Practice Address - Phone:718-442-8588
Practice Address - Fax:718-442-6737
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017482-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist