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General NPI Number Information
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NPI Number | 1619251469
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Entity Type | Individual
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Provider Name | NICOLE NOEL RICCI ED.D., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 16-10 UTOPIA PARKWAY THIRD FLOOR, ROOM 303 P9@209Q
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City | WHITESTONE
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State | NY
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Zip | 11357
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Country | US
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Telephone | 718-352-7075
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 MAPLE DR
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3042
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Country | US
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Telephone | 516-270-2519
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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 | 020949-1
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License Number State | NY
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