Provider Demographics
NPI:1538313846
Name:ORMANIDHI, RAVENA (MA CCC-SLP TSHH)
Entity Type:Individual
Prefix:
First Name:RAVENA
Middle Name:
Last Name:ORMANIDHI
Suffix:
Gender:F
Credentials:MA CCC-SLP TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 GRAND CONCOURSE APT 1D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1350
Mailing Address - Country:US
Mailing Address - Phone:718-364-8934
Mailing Address - Fax:
Practice Address - Street 1:3050 GRAND CONCOURSE APT 1D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1350
Practice Address - Country:US
Practice Address - Phone:718-364-8934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015779-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist