Provider Demographics
NPI:1679880017
Name:DINER, SALOMON (MS,CCC, SLP)
Entity type:Individual
Prefix:
First Name:SALOMON
Middle Name:
Last Name:DINER
Suffix:
Gender:M
Credentials:MS,CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3607
Mailing Address - Country:US
Mailing Address - Phone:718-382-9397
Mailing Address - Fax:
Practice Address - Street 1:949 E 12TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3607
Practice Address - Country:US
Practice Address - Phone:718-382-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015952-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist