Provider Demographics
NPI:1851132922
Name:NAIM LAVIAN, ILANA LIBBY (MS, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:MRS
First Name:ILANA
Middle Name:LIBBY
Last Name:NAIM LAVIAN
Suffix:
Gender:F
Credentials:MS, 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 1:600 WEST 239TH
Mailing Address - Street 2:APT #3M
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463
Mailing Address - Country:US
Mailing Address - Phone:917-848-9703
Mailing Address - Fax:
Practice Address - Street 1:1032 MAIN ST
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3520
Practice Address - Country:US
Practice Address - Phone:845-897-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033213235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist