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NPI 1811250996

NPI 1811250996 : PAULA V PINEDA SLP-CCC, TSSLD : ELMHURST, NY

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General NPI Number Information
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    NPI Number           |    1811250996
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    Entity Type          |    Individual 
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    Provider Name        |    PAULA V PINEDA SLP-CCC, TSSLD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/22/2012
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    Last Update Date     |    04/11/2021
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Provider Practice Location Address
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    Address Line         |    8528 BRITTON AVE 
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    City                 |    ELMHURST
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    State                |    NY
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    Zip                  |    11373-1434
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    Country              |    US
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    Telephone            |    718-898-2230
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8528 BRITTON AVE 
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    City                 |    ELMHURST
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    State                |    NY
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    Zip                  |    11373-1434
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    Country              |    US
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    Telephone            |    718-898-2230
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    022518
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    License Number State |    NY
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