Provider Demographics
NPI:1407348212
Name:D'ELIA, KRISTIE LYNN (MA CCC-SLP, TSSLD)
Entity type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:LYNN
Last Name:D'ELIA
Suffix:
Gender:F
Credentials:MA CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ROSS LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2519
Mailing Address - Country:US
Mailing Address - Phone:631-356-2336
Mailing Address - Fax:
Practice Address - Street 1:2 6TH AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-6110
Practice Address - Country:US
Practice Address - Phone:631-434-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1231755181OtherNEW YORK STATE