Provider Demographics
NPI:1790118511
Name:SIEGEL, DANA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HUDSON ST
Mailing Address - Street 2:APT 508
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5854
Mailing Address - Country:US
Mailing Address - Phone:412-841-4599
Mailing Address - Fax:
Practice Address - Street 1:4125 163RD ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2657
Practice Address - Country:US
Practice Address - Phone:718-571-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist