Provider Demographics
NPI:1376165472
Name:GOCIU, INGRID (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:GOCIU
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3413 34TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1251
Mailing Address - Country:US
Mailing Address - Phone:347-531-2566
Mailing Address - Fax:
Practice Address - Street 1:PIRMASENSER STRASSE 36
Practice Address - Street 2:
Practice Address - City:KAISERSLAUTERN
Practice Address - State:RHEINLAND-PFALZ
Practice Address - Zip Code:67655
Practice Address - Country:DE
Practice Address - Phone:347-531-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty