Provider Demographics
NPI:1265959167
Name:GERARDI, DIANA (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:GERARDI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:WILLNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:3840 BEECHWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2025
Mailing Address - Country:US
Mailing Address - Phone:516-589-2434
Mailing Address - Fax:
Practice Address - Street 1:1225 FRANKLIN AVE STE 325
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1693
Practice Address - Country:US
Practice Address - Phone:516-512-8905
Practice Address - Fax:516-543-0664
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist