Provider Demographics
NPI:1437335478
Name:FELIZ, AIDA G (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:G
Last Name:FELIZ
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W 25TH ST APT 9H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2137
Mailing Address - Country:US
Mailing Address - Phone:201-766-2517
Mailing Address - Fax:
Practice Address - Street 1:55 W 25TH ST APT 9H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2137
Practice Address - Country:US
Practice Address - Phone:201-766-2517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016136-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist