Glenda Ivone Alvarado, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Wantagh, NY

NPI 1467686808 · NPPES record last updated Jun 30, 2015

Key facts

NPI
1467686808
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
018697-1 (NY)
Practice address
3201 Waterbury Dr
Wantagh, NY 11793-3331
Phone
(917) 647-7348
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
018697-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Developing Speech, P.C. Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 018697-1 NY Yes

Addresses

Primary practice location

3201 Waterbury Dr
Wantagh, NY 11793-3331

Mailing address

3201 Waterbury Dr
Wantagh, NY 11793-3331
Phone (917) 647-7348

Other providers in Wantagh, NY

All providers in Wantagh, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.