Provider Demographics
NPI:1265563159
Name:STONE, IRIS DANKNER (MA CCCA)
Entity type:Individual
Prefix:MS
First Name:IRIS
Middle Name:DANKNER
Last Name:STONE
Suffix:
Gender:F
Credentials:MA CCCA
Other - Prefix:MS
Other - First Name:IRIS
Other - Middle Name:ELLEN
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4764 PARK GRANADA
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1545
Mailing Address - Country:US
Mailing Address - Phone:818-222-4327
Mailing Address - Fax:818-222-4328
Practice Address - Street 1:4764 PARK GRANADA
Practice Address - Street 2:SUITE 109
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1545
Practice Address - Country:US
Practice Address - Phone:818-222-4327
Practice Address - Fax:818-222-4328
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001718231H00000X
NY14000005197237600000X
CA2480237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01893145Medicaid
NY02742785Medicaid
NY02742785Medicaid