Provider Demographics
NPI:1013157890
Name:KEIDAR, ANAT (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:ANAT
Middle Name:
Last Name:KEIDAR
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:DR
Other - First Name:ANAT
Other - Middle Name:
Other - Last Name:KEIDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPEECH PATHOLOGIST
Mailing Address - Street 1:210 WEST 101 STREET
Mailing Address - Street 2:#12-B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5038
Mailing Address - Country:US
Mailing Address - Phone:212-600-4197
Mailing Address - Fax:212-866-6052
Practice Address - Street 1:210 WEST 101 STREET
Practice Address - Street 2:#12-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5038
Practice Address - Country:US
Practice Address - Phone:212-600-4197
Practice Address - Fax:212-866-6052
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007118-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01038090OtherAMERICAN SPEECH LANGUAGE ASSOCIATION