Provider Demographics
NPI:1447147491
Name:GLADYSZ, GAGE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GAGE
Middle Name:
Last Name:GLADYSZ
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4306 OVERLOOK CIR
Mailing Address - Street 2:
Mailing Address - City:PIERMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10968-1292
Mailing Address - Country:US
Mailing Address - Phone:724-456-8314
Mailing Address - Fax:
Practice Address - Street 1:4306 OVERLOOK CIR
Practice Address - Street 2:
Practice Address - City:PIERMONT
Practice Address - State:NY
Practice Address - Zip Code:10968-1292
Practice Address - Country:US
Practice Address - Phone:724-456-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist