Provider Demographics
NPI:1114280369
Name:DLGG ENTERPRISES
Entity Type:Organization
Organization Name:DLGG ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GAMBINO GADES
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP, PC
Authorized Official - Phone:917-957-9797
Mailing Address - Street 1:60 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3440
Mailing Address - Country:US
Mailing Address - Phone:917-957-9797
Mailing Address - Fax:
Practice Address - Street 1:60 WILLOW ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3440
Practice Address - Country:US
Practice Address - Phone:917-957-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012435235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty