Provider Demographics
NPI:1619121696
Name:KLAYN, NELLY (SLP)
Entity Type:Individual
Prefix:
First Name:NELLY
Middle Name:
Last Name:KLAYN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:NELLY
Other - Middle Name:
Other - Last Name:GERTOPSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1392 E 14TH ST
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1392 E 14TH ST
Practice Address - Street 2:FLOOR 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5902
Practice Address - Country:US
Practice Address - Phone:646-338-6449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017436235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist