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General NPI Number Information
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NPI Number | 1689341406
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Entity Type | Individual
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Provider Name | JULIANA COLON CCC-SLP TSSLD
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Gender | Female
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Dates
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Enumeration Date | 08/28/2021
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Last Update Date | 08/28/2021
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Provider Practice Location Address
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Address Line | 33 FERNDALE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4843
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Country | US
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Telephone | 718-698-5757
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Fax |
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Provider Business Mailing Address
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Address Line | 14 VILLANOVA ST
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6032
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Country | US
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Telephone | 718-619-0980
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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 | 031038
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License Number State | NY
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