Provider Demographics
NPI:1861769994
Name:GOZDZIEWSKI, TERRY HAUSNER (TSHH, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:HAUSNER
Last Name:GOZDZIEWSKI
Suffix:
Gender:F
Credentials:TSHH, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7135 252ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2742
Mailing Address - Country:US
Mailing Address - Phone:718-347-3641
Mailing Address - Fax:
Practice Address - Street 1:1601 NEWBRIDGE RD
Practice Address - Street 2:NEWBRIDGE ROAD ELEMENTARY SCHOOL
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1603
Practice Address - Country:US
Practice Address - Phone:516-992-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58-003461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist