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General NPI Number Information
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NPI Number | 1346493301
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Entity Type | Organization
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Legal Business Name | GIFTOS AND MAZZONE, CO.,INC.
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 519 NATHANIEL DR
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City | SCHENECTADY
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State | NY
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Zip | 12303-5652
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Country | US
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Telephone | 518-361-1022
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Fax | 866-788-7140
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Provider Business Mailing Address
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Address Line | 519 NATHANIEL DR
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City | SCHENECTADY
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State | NY
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Zip | 12303-5652
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Country | US
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Telephone | 518-361-1022
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Fax | 866-788-7140
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | JOANNA JOAN MAZZONE
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Credential | MS CCC-SLP
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Telephone | 518-361-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 004188-1
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License Number State | NY
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