MEDICARE: MRS. SILVIA MARINELLO-DIMINO MACCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	012267	NY
2	235Z00000X	Speech-Language Pathologist	4366	NJ

General Provider Information

NPI Number	:	1306091004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SILVIA MARINELLO-DIMINO MACCC-SLP

Provider Business Mailing Address
First Line	:	7 HANNAH MOUNT DR
Second Line	:
City	:	CLARKSBURG
State	:	NJ
Zip	:	08510-1723
Country	:	US
Telephone Number	:	347-661-1515
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 HANNAH MOUNT DR
Second Line	:
City	:	CLARKSBURG
State	:	NJ
Zip	:	08510-1723
Country	:	US
Telephone Number	:	347-661-1515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2008
Last Update Date	:	11/21/2008

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