Healthcare Provider Details

I. General information

NPI: 1073826921
Provider Name (Legal Business Name): MARTHA D GELL SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA D GELL-MATTHEWS SLP

II. Dates (important events)

Enumeration Date: 07/21/2010
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 HAWTHORNE AVE
YONKERS NY
10705-3441
US

IV. Provider business mailing address

203 CHRISTIE ST
RIDGEFIELD PARK NJ
07660-2002
US

V. Phone/Fax

Practice location:
  • Phone: 914-375-8906
  • Fax:
Mailing address:
  • Phone: 917-842-5053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number014285-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: