Healthcare Provider Details

I. General information

NPI: 1164330700
Provider Name (Legal Business Name): PIA CISTERNINO M.A., M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PIA MARRELLA M.A., M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

L16 FARMHOUSE LN
MORRISTOWN NJ
07960-3012
US

IV. Provider business mailing address

L16 FARMHOUSE LN
MORRISTOWN NJ
07960-3012
US

V. Phone/Fax

Practice location:
  • Phone: 646-245-9314
  • Fax:
Mailing address:
  • Phone: 646-245-9314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number013390
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: