Provider Demographics
NPI:1396976791
Name:CELNIK, MINA MAZAL (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MINA
Middle Name:MAZAL
Last Name:CELNIK
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MINA
Other - Middle Name:MAZAL
Other - Last Name:ABADY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:489 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4507
Mailing Address - Country:US
Mailing Address - Phone:718-854-7987
Mailing Address - Fax:
Practice Address - Street 1:489 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4507
Practice Address - Country:US
Practice Address - Phone:718-854-7987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017092-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist