Provider Demographics
NPI:1699460014
Name:ADLER, GOLDA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GOLDA
Middle Name:
Last Name:ADLER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HOPE ST APT 212
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4865
Mailing Address - Country:US
Mailing Address - Phone:845-499-3394
Mailing Address - Fax:
Practice Address - Street 1:842 LEFFERTS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1301
Practice Address - Country:US
Practice Address - Phone:718-778-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032377235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist