Provider Demographics
NPI:1659518801
Name:HADAMIK, DENISE A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:HADAMIK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ANTOINETTE DR
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-1206
Mailing Address - Country:US
Mailing Address - Phone:607-754-3469
Mailing Address - Fax:607-754-3469
Practice Address - Street 1:212 ANTOINETTE DR
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-1206
Practice Address - Country:US
Practice Address - Phone:607-754-3469
Practice Address - Fax:607-754-3469
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003628-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist