Provider Demographics
NPI:1497035778
Name:GOLDBLATT, DENA JUDITH (MA,CCC,SLP)
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:JUDITH
Last Name:GOLDBLATT
Suffix:
Gender:F
Credentials:MA,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1606
Mailing Address - Country:US
Mailing Address - Phone:516-295-1438
Mailing Address - Fax:516-295-4823
Practice Address - Street 1:918 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1606
Practice Address - Country:US
Practice Address - Phone:516-295-1438
Practice Address - Fax:516-295-4823
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002353235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist