Provider Demographics
NPI:1447495270
Name:SIEBERG, GIGI CHUNG (MS ED, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:GIGI
Middle Name:CHUNG
Last Name:SIEBERG
Suffix:
Gender:F
Credentials:MS ED, CCC-SLP
Other - Prefix:MS
Other - First Name:SUK CHI
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED, CCC-SLP
Mailing Address - Street 1:1855 STILLWELL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2439
Mailing Address - Country:US
Mailing Address - Phone:718-627-7550
Mailing Address - Fax:
Practice Address - Street 1:1855 STILLWELL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2439
Practice Address - Country:US
Practice Address - Phone:718-627-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014767235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist