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General NPI Number Information
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NPI Number | 1407637556
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Entity Type | Organization
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Legal Business Name | CONSCIOUSLY CONNECTED CORP
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 22421 64TH AVE
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-2326
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Country | US
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Telephone | 247-259-0763
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Fax |
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Provider Business Mailing Address
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Address Line | 22421 64TH AVE
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-2326
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARISA TAORMINA
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Credential |
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Telephone | 347-259-0763
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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 |
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License Number State |
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