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General NPI Number Information
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NPI Number | 1518331339
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Entity Type | Organization
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Legal Business Name | MICHELLE MARCIANO SLP P.C.
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 700 AUSTIN STREET SUITE 200
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 516-426-7414
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Fax |
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Provider Business Mailing Address
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Address Line | 211 HARBORVIEW S
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City | LAWRENCE
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State | NY
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Zip | 11559-1909
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Country | US
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Telephone | 516-426-7414
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | MICHELLE MARCIANO
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Credential | M.S., CCC-SLP
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Telephone | 516-426-7414
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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 | 019330
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License Number State | NY
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