Provider Demographics
NPI:1881987451
Name:MELENDEZ-BRISKIE, SILVIA E (SLP)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:E
Last Name:MELENDEZ-BRISKIE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 9TH AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2305
Mailing Address - Country:US
Mailing Address - Phone:917-822-5940
Mailing Address - Fax:866-756-0662
Practice Address - Street 1:4600 9TH AVE APT 103
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2305
Practice Address - Country:US
Practice Address - Phone:917-822-5940
Practice Address - Fax:866-756-0662
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY020963-1OtherLICENSE#