Provider Demographics
NPI:1295263093
Name:JIMENEZ GONZALEZ, SAIDA BEATRIZ
Entity type:Individual
Prefix:
First Name:SAIDA
Middle Name:BEATRIZ
Last Name:JIMENEZ GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SMITH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4614
Mailing Address - Country:US
Mailing Address - Phone:914-565-3455
Mailing Address - Fax:914-328-2973
Practice Address - Street 1:2700 WESTCHESTER AVE STE 300
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2554
Practice Address - Country:US
Practice Address - Phone:914-328-2868
Practice Address - Fax:914-328-2973
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist