Provider Demographics
NPI:1952573669
Name:SORRENTINO, GAYLE ELIZABETH (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:ELIZABETH
Last Name:SORRENTINO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:430 LAKEVILLE ROAD
Mailing Address - Street 2:HEARING AND SPEECH CENTER
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:718-470-8910
Mailing Address - Fax:718-347-8241
Practice Address - Street 1:430 LAKEVILLE ROAD
Practice Address - Street 2:NORTH SHORE LIJ HEARING AND SPEECH CENTER
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:718-470-8910
Practice Address - Fax:718-347-8241
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002245235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist