Healthcare Provider Details

I. General information

NPI: 1609946490
Provider Name (Legal Business Name): MICHELLE CHRISTINE ADAMO M.S.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 5TH AVE
WATERVLIET NY
12189-3610
US

IV. Provider business mailing address

716 5TH AVE
WATERVLIET NY
12189-3610
US

V. Phone/Fax

Practice location:
  • Phone: 518-779-9315
  • Fax:
Mailing address:
  • Phone: 518-779-9315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number014971-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: