Provider Demographics
NPI:1962076067
Name:ZGALJARDIC LYTRAS, ANA MARIJA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIJA
Last Name:ZGALJARDIC LYTRAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CEDARWOOD HALL
Mailing Address - Street 2:20 HOSPITAL OVAL W
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:646-228-4762
Mailing Address - Fax:
Practice Address - Street 1:CEDARWOOD HALL
Practice Address - Street 2:20 HOSPITAL OVAL W
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:646-228-4762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist