Provider Demographics
NPI:1427493808
Name:SVERDLOVA-SAMARDIN, ADELINA (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ADELINA
Middle Name:
Last Name:SVERDLOVA-SAMARDIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ADELINA
Other - Middle Name:
Other - Last Name:SVERDLOVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8930 114TH ST
Mailing Address - Street 2:ROOM 510
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-3028
Mailing Address - Country:US
Mailing Address - Phone:718-207-2727
Mailing Address - Fax:
Practice Address - Street 1:8930 114TH ST
Practice Address - Street 2:ROOM 510
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-3028
Practice Address - Country:US
Practice Address - Phone:718-207-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022564-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist