Provider Demographics
NPI:1215210166
Name:DADURKA-O'CONNELL, CHRISTINE JOAN (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JOAN
Last Name:DADURKA-O'CONNELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 S GOODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3769
Mailing Address - Country:US
Mailing Address - Phone:914-592-4615
Mailing Address - Fax:914-592-4258
Practice Address - Street 1:98 S GOODWIN AVE
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3769
Practice Address - Country:US
Practice Address - Phone:914-592-4615
Practice Address - Fax:914-592-4258
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004896-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist