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General NPI Number Information
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NPI Number | 1821308123
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Entity Type | Individual
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Provider Name | CHRISTINE RUOLO M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 47 CROYDON ROAD
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City | YONKERS
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State | NY
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Zip | 10710
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Country | US
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Telephone | 914-376-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 1248 NORTH RIDGE ROAD
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City | SHRUB OAK
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State | NY
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Zip | 10588
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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 |
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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 | 016165
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License Number State | NY
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