Provider Demographics
NPI:1336894070
Name:BELTRE, ANGIE L (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANGIE
Middle Name:L
Last Name:BELTRE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 DELANOY AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6249
Mailing Address - Country:US
Mailing Address - Phone:718-213-7016
Mailing Address - Fax:
Practice Address - Street 1:1000 TELLER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-6105
Practice Address - Country:US
Practice Address - Phone:718-588-8308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031658235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist