Provider Demographics
NPI:1093124869
Name:KOLODNY, RIVKA (SLP CCC MA)
Entity Type:Individual
Prefix:
First Name:RIVKA
Middle Name:
Last Name:KOLODNY
Suffix:
Gender:F
Credentials:SLP CCC MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6704
Mailing Address - Country:US
Mailing Address - Phone:347-213-7186
Mailing Address - Fax:
Practice Address - Street 1:25 SUMMIT RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-6704
Practice Address - Country:US
Practice Address - Phone:347-213-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist