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General NPI Number Information
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NPI Number | 1780987545
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Entity Type | Individual
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Provider Name | ANDREA ERICA SORRENTINO M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 777 ROSSVILLE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10309-1707
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Country | US
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Telephone | 407-760-9733
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Fax |
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Provider Business Mailing Address
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Address Line | 777 ROSSVILLE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10309-1707
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Country | US
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Telephone | 407-760-9733
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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 | SA10010
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 41YS00650600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 022520
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License Number State | NY
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