Provider Demographics
NPI:1861844409
Name:ELLEN NADELL-SIEGEL MA-SLP PLLC
Entity Type:Organization
Organization Name:ELLEN NADELL-SIEGEL MA-SLP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NADELL-SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA-SLP
Authorized Official - Phone:917-868-3737
Mailing Address - Street 1:16 COLGATE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2222
Mailing Address - Country:US
Mailing Address - Phone:917-868-3737
Mailing Address - Fax:
Practice Address - Street 1:16 COLGATE RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2222
Practice Address - Country:US
Practice Address - Phone:917-868-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4144-1235Z00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty