Provider Demographics
NPI:1902032923
Name:SIDOTI, ROBIN G (MS/CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:G
Last Name:SIDOTI
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:G
Other - Last Name:SECCAFICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 SAWYERS PEAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924
Mailing Address - Country:US
Mailing Address - Phone:917-922-5800
Mailing Address - Fax:845-988-5087
Practice Address - Street 1:2004- RT 17M
Practice Address - Street 2:
Practice Address - City:GOSNER
Practice Address - State:NY
Practice Address - Zip Code:10924
Practice Address - Country:US
Practice Address - Phone:845-294-0661
Practice Address - Fax:845-988-5087
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7056-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist