Provider Demographics
NPI:1689819872
Name:BENDER, GAIL CARLIN (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:CARLIN
Last Name:BENDER
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 1:1377 STEVENSON RD
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1713
Mailing Address - Country:US
Mailing Address - Phone:516-569-6135
Mailing Address - Fax:
Practice Address - Street 1:1377 STEVENSON RD
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1713
Practice Address - Country:US
Practice Address - Phone:516-569-6135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0000633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist