Provider Demographics
NPI:1780997932
Name:GERSHKOVICH, BIANA (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:BIANA
Middle Name:
Last Name:GERSHKOVICH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3692 BEDFORD AVENUE
Mailing Address - Street 2:APT # 3A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:917-470-1060
Mailing Address - Fax:
Practice Address - Street 1:3692 BEDFORD AVE
Practice Address - Street 2:APT # 3A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1704
Practice Address - Country:US
Practice Address - Phone:917-470-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020159235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist