Provider Demographics
NPI:1881575249
Name:GAVIDIA, REBECCA MERKER (CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MERKER
Last Name:GAVIDIA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:MERKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 VIRGINIA PL APT 1W
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2040
Mailing Address - Country:US
Mailing Address - Phone:914-815-5535
Mailing Address - Fax:
Practice Address - Street 1:480 ALBANY POST RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-2438
Practice Address - Country:US
Practice Address - Phone:914-941-9513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035962235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist