Provider Demographics
NPI:1265685226
Name:GILROY, EILEEN REDINGTON (MS/CCC/SLP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:REDINGTON
Last Name:GILROY
Suffix:
Gender:F
Credentials:MS/CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 WINDING RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-1056
Mailing Address - Country:US
Mailing Address - Phone:607-768-6758
Mailing Address - Fax:
Practice Address - Street 1:315 WINDING RIDGE RD
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-1056
Practice Address - Country:US
Practice Address - Phone:607-768-6758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004453-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist