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General NPI Number Information
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NPI Number | 1104101146
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Entity Type | Individual
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Provider Name | MARY A. CARRIGAN-PEEK SLP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 2719 HAMBURG ST
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City | SCHENECTADY
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State | NY
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Zip | 12303-3722
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Country | US
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Telephone | 518-356-8400
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Fax | 518-356-8404
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Provider Business Mailing Address
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Address Line | 2072 CURRY RD
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City | SCHENECTADY
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State | NY
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Zip | 12303-4400
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Country | US
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Telephone | 518-356-8200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 004929-1
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License Number State | NY
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