=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831031913
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LIANUSKA LUPE GUTIERREZ CF-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2026
-----------------------------------------------------
Last Update Date | 04/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8403 57TH AVE
-----------------------------------------------------
City | ELMHURST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11373-4833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-899-9060
-----------------------------------------------------
Fax | 718-899-9061
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 271 SIP AVE UNIT 601
-----------------------------------------------------
City | JERSEY CITY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07306-7115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-952-3958
-----------------------------------------------------
Fax | 347-952-3958
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------