Provider Demographics
NPI:1780478487
Name:KERSTEIN, ILANA (MA CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:ILANA
Middle Name:
Last Name:KERSTEIN
Suffix:
Gender:
Credentials:MA CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 COLUMBUS AVE APT 4J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6476
Mailing Address - Country:US
Mailing Address - Phone:201-618-8128
Mailing Address - Fax:
Practice Address - Street 1:750 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6464
Practice Address - Country:US
Practice Address - Phone:201-618-8128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033145235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist