Provider Demographics
NPI:1215185483
Name:ERDOS, DAVID STEVEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:STEVEN
Last Name:ERDOS
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:S
Other - Last Name:ERDOS, LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1610 HEREFORD RD
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1804
Mailing Address - Country:US
Mailing Address - Phone:917-691-7416
Mailing Address - Fax:516-791-3444
Practice Address - Street 1:1610 HEREFORD RD
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1804
Practice Address - Country:US
Practice Address - Phone:917-691-7416
Practice Address - Fax:516-791-3444
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012143-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist