Provider Demographics
NPI:1811491871
Name:ASTORIA SPEECH PATHOLOGY AND VOICE CARE PLLC
Entity type:Organization
Organization Name:ASTORIA SPEECH PATHOLOGY AND VOICE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HINNAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:914-469-9760
Mailing Address - Street 1:2109 46TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1333
Mailing Address - Country:US
Mailing Address - Phone:914-469-9760
Mailing Address - Fax:718-744-9643
Practice Address - Street 1:2138 31ST ST STE 1B
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2657
Practice Address - Country:US
Practice Address - Phone:718-626-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016469261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech