Provider Demographics
NPI:1255587556
Name:BRANDSDORFER, AVIVA (MS)
Entity type:Individual
Prefix:
First Name:AVIVA
Middle Name:
Last Name:BRANDSDORFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E SHORE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2900
Mailing Address - Country:US
Mailing Address - Phone:516-482-0923
Mailing Address - Fax:
Practice Address - Street 1:333 E SHORE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2900
Practice Address - Country:US
Practice Address - Phone:516-482-0923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist