Provider Demographics
NPI:1710322060
Name:DYNDA, EWA D (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:D
Last Name:DYNDA
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 1:7 THRUSH LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-3210
Mailing Address - Country:US
Mailing Address - Phone:516-622-0035
Mailing Address - Fax:
Practice Address - Street 1:45 N STATION PLZ
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5033
Practice Address - Country:US
Practice Address - Phone:516-622-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018172235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist