Healthcare Provider Details

I. General information

NPI: 1699601971
Provider Name (Legal Business Name): BRIANNA ROSE MARFA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 FANNING ST
STATEN ISLAND NY
10314-5307
US

IV. Provider business mailing address

79 STARBUCK ST
STATEN ISLAND NY
10304-1731
US

V. Phone/Fax

Practice location:
  • Phone: 718-289-7900
  • Fax:
Mailing address:
  • Phone: 347-563-7490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number036721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: