Provider Demographics
NPI:1720396948
Name:KOLENDA, NICOLE (MS, CCC-SLP, PC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:KOLENDA
Suffix:
Gender:F
Credentials:MS, CCC-SLP, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 EWELER AVENUE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3712
Mailing Address - Country:US
Mailing Address - Phone:646-228-2821
Mailing Address - Fax:
Practice Address - Street 1:114 E 71ST ST
Practice Address - Street 2:SUITE 1E, OFFICE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5040
Practice Address - Country:US
Practice Address - Phone:212-439-6108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012409235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist