Provider Demographics
NPI:1548588353
Name:GELDWERT, NILI (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NILI
Middle Name:
Last Name:GELDWERT
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 1:334 W 88TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2200
Mailing Address - Country:US
Mailing Address - Phone:917-575-2906
Mailing Address - Fax:
Practice Address - Street 1:334 W 88TH ST APT 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2200
Practice Address - Country:US
Practice Address - Phone:917-575-2906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist