Healthcare Provider Details

I. General information

NPI: 1770025686
Provider Name (Legal Business Name): HEIDI UDVARDY CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 LOCKWOOD AVE
NEW ROCHELLE NY
10801-5023
US

IV. Provider business mailing address

164 CHURCH ST
NEW ROCHELLE NY
10805-3254
US

V. Phone/Fax

Practice location:
  • Phone: 914-575-0600
  • Fax:
Mailing address:
  • Phone: 917-803-5527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number027397
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: