Healthcare Provider Details

I. General information

NPI: 1043959513
Provider Name (Legal Business Name): ALLISON SANASIE MS SLP-CCC TSSLD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 THIERIOT AVE
BRONX NY
10473-2920
US

IV. Provider business mailing address

560 THIERIOT AVE
BRONX NY
10473-2920
US

V. Phone/Fax

Practice location:
  • Phone: 718-378-4736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number036951
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: