Provider Demographics
NPI:1578123568
Name:GELARDI, DANIELLE KRISTYN
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KRISTYN
Last Name:GELARDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:KRISTYN
Other - Last Name:LERRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CLAREWOOD DRIVE
Mailing Address - Street 2:APT. 5H
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706
Mailing Address - Country:US
Mailing Address - Phone:914-980-4344
Mailing Address - Fax:
Practice Address - Street 1:2975 WESTCHESTER AVE STE 202
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2500
Practice Address - Country:US
Practice Address - Phone:914-980-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030196235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06372178Medicaid