Provider Demographics
NPI:1851534689
Name:ESTRELLA, ANGELA M
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:ESTRELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:ESTRELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC SLP
Mailing Address - Street 1:23 OLD MAMARONECK RD
Mailing Address - Street 2:APT. 3-0
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2061
Mailing Address - Country:US
Mailing Address - Phone:914-682-4227
Mailing Address - Fax:
Practice Address - Street 1:151 E 67TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5964
Practice Address - Country:US
Practice Address - Phone:212-988-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0079141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009714-1OtherNEW YORK STATE EDUCATION DEPARTMENT PROFESSIONAL LICENSE