Provider Demographics
NPI:1710259700
Name:SALAZAR, YANELA (M A, SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:YANELA
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:M A, SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 SEDGWICK AVE
Mailing Address - Street 2:APT #3B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4444
Mailing Address - Country:US
Mailing Address - Phone:646-210-8737
Mailing Address - Fax:
Practice Address - Street 1:3845 SEDGWICK AVE APT 3B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4445
Practice Address - Country:US
Practice Address - Phone:646-210-8737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02169001235Z00000X
NY021690235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist