Provider Demographics
NPI:1669788592
Name:ADLER, BERYL T (MSCCC/SLP)
Entity type:Individual
Prefix:MS
First Name:BERYL
Middle Name:T
Last Name:ADLER
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E 57TH ST
Mailing Address - Street 2:11C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2935
Mailing Address - Country:US
Mailing Address - Phone:917-882-3044
Mailing Address - Fax:718-338-1411
Practice Address - Street 1:2425 KINGS HWY
Practice Address - Street 2:A9
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1670
Practice Address - Country:US
Practice Address - Phone:718-338-1729
Practice Address - Fax:718-338-1411
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001188-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist