Provider Demographics
NPI:1306153101
Name:HIKELIN, ILENE
Entity type:Individual
Prefix:MS
First Name:ILENE
Middle Name:
Last Name:HIKELIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 SHORE RD
Mailing Address - Street 2:APT. 415
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6113
Mailing Address - Country:US
Mailing Address - Phone:718-491-2474
Mailing Address - Fax:
Practice Address - Street 1:915 BROADWAY
Practice Address - Street 2:SUITE 1307
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7108
Practice Address - Country:US
Practice Address - Phone:347-529-5428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018547-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist