Provider Demographics
NPI:1902181928
Name:EMIGH, GINA T (M A , CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:T
Last Name:EMIGH
Suffix:
Gender:F
Credentials:M A , CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EDUCATION DR
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-4066
Mailing Address - Country:US
Mailing Address - Phone:845-838-6900
Mailing Address - Fax:845-231-0474
Practice Address - Street 1:10 EDUCATION DR
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-4066
Practice Address - Country:US
Practice Address - Phone:845-838-6900
Practice Address - Fax:845-231-0474
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004760-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY251300000Medicaid