Provider Demographics
NPI:1518304187
Name:ADLER, ERICA M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:M
Last Name:ADLER
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 1:474 OVINGTON AVE
Mailing Address - Street 2:APT 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1550
Mailing Address - Country:US
Mailing Address - Phone:917-562-3033
Mailing Address - Fax:347-578-7436
Practice Address - Street 1:474 OVINGTON AVE
Practice Address - Street 2:APT 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1550
Practice Address - Country:US
Practice Address - Phone:917-562-3033
Practice Address - Fax:347-578-7436
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021192235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist