Provider Demographics
NPI:1841509833
Name:NEDELKA, ANNE MARIE (SLP, CCC)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:NEDELKA
Suffix:
Gender:F
Credentials:SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-4344
Mailing Address - Country:US
Mailing Address - Phone:516-935-2023
Mailing Address - Fax:
Practice Address - Street 1:240 WILLOW ST
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1253
Practice Address - Country:US
Practice Address - Phone:516-801-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-25
Last Update Date:2010-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005357-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist