Provider Demographics
NPI:1750671483
Name:GURA STOCK, RHONDA BETH (SPEECH/LANGUAGE PATH)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:BETH
Last Name:GURA STOCK
Suffix:
Gender:F
Credentials:SPEECH/LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 BLACKSTONE AVE APT 9J
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3721
Mailing Address - Country:US
Mailing Address - Phone:917-620-5726
Mailing Address - Fax:
Practice Address - Street 1:1250 WARD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-2406
Practice Address - Country:US
Practice Address - Phone:917-620-5726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005-101235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist