Provider Demographics
NPI:1730322801
Name:BELAU, IRINA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:BELAU
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2639
Mailing Address - Country:US
Mailing Address - Phone:347-768-0220
Mailing Address - Fax:718-645-0065
Practice Address - Street 1:1875 W 7TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2639
Practice Address - Country:US
Practice Address - Phone:347-768-0220
Practice Address - Fax:718-645-0065
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-19
Last Update Date:2009-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist