Provider Demographics
NPI:1306269212
Name:DELCUADRO SLP PC
Entity type:Organization
Organization Name:DELCUADRO SLP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:DAMIAN
Authorized Official - Last Name:DELCUADRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-377-8001
Mailing Address - Street 1:1215 ASTORIA BLVD
Mailing Address - Street 2:APT. 4 R
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3696
Mailing Address - Country:US
Mailing Address - Phone:646-377-8001
Mailing Address - Fax:
Practice Address - Street 1:1215 ASTORIA BLVD
Practice Address - Street 2:APT. 4 R
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3696
Practice Address - Country:US
Practice Address - Phone:646-377-8001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty