Healthcare Provider Details

I. General information

NPI: 1427328996
Provider Name (Legal Business Name): BRENDA GELZER-HILL MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2011
Last Update Date: 12/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 BELLOWS TERRACE RD.
HAMPTON BAYS NY
11946-3503
US

IV. Provider business mailing address

4 BELLOWS TERRACE RD
HAMPTON BAYS NY
11946-3503
US

V. Phone/Fax

Practice location:
  • Phone: 631-723-2593
  • Fax:
Mailing address:
  • Phone: 631-723-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number004404-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: