Provider Demographics
NPI:1053611665
Name:LEBOVIC, GITTY
Entity type:Individual
Prefix:
First Name:GITTY
Middle Name:
Last Name:LEBOVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GITTEL
Other - Middle Name:C
Other - Last Name:CUKIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8 KEW GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7101
Mailing Address - Country:US
Mailing Address - Phone:732-905-0820
Mailing Address - Fax:
Practice Address - Street 1:8 KEW GARDENS DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7101
Practice Address - Country:US
Practice Address - Phone:732-905-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist