Provider Demographics
NPI:1831420025
Name:RADUNSKY, VERA A (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:A
Last Name:RADUNSKY
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 1:2 S PINEHURST AVE
Mailing Address - Street 2:#2D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6627
Mailing Address - Country:US
Mailing Address - Phone:917-362-2087
Mailing Address - Fax:
Practice Address - Street 1:2 S PINEHURST AVE
Practice Address - Street 2:#2D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6627
Practice Address - Country:US
Practice Address - Phone:917-362-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019529235Z00000X
NJ41YS00611500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist