Provider Demographics
NPI:1710256243
Name:SLOTKIN, DINA
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:SLOTKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14006 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1637
Mailing Address - Country:US
Mailing Address - Phone:718-575-8299
Mailing Address - Fax:
Practice Address - Street 1:12450 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2700
Practice Address - Country:US
Practice Address - Phone:718-847-5352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY468758931235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist