Provider Demographics
NPI:1457900235
Name:CAROL GELLER, SLP-C
Entity Type:Organization
Organization Name:CAROL GELLER, SLP-C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:631-757-4289
Mailing Address - Street 1:298 MEDEA WAY
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-4540
Mailing Address - Country:US
Mailing Address - Phone:631-757-4289
Mailing Address - Fax:631-757-6313
Practice Address - Street 1:298 MEDEA WAY
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-4540
Practice Address - Country:US
Practice Address - Phone:631-757-4289
Practice Address - Fax:631-757-6313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty