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General NPI Number Information
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NPI Number | 1316462187
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Entity Type | Individual
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Provider Name | MARISA N GARGARO
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Gender | Female
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Dates
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Enumeration Date | 08/13/2017
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 2537 ROUTE 52
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-3229
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Country | US
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Telephone | 914-469-7449
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 NY-9D
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City | GARRISON
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State | NY
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Zip | 10524
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Country | US
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Telephone | 845-424-3689
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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 | 027961
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License Number State | NY
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