MEDICARE: ANTHONY PAVONE

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

General Provider Information

NPI Number	:	1679114870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY PAVONE

Provider Business Mailing Address
First Line	:	1276 PULASKI RD
Second Line	:
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-2020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 HAWKINS AVE
Second Line	:
City	:	LAKE RONKONKOMA
State	:	NY
Zip	:	11779-2374
Country	:	US
Telephone Number	:	631-240-3579
Fax Number	:

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

Provider Enumeration Date	:	09/30/2019
Last Update Date	:	09/30/2019

Similar Medicare Providers

1386197085 — BRITTANY KISS PA-C, DAT
Practice Location Address:

622 HAWKINS AVE
LAKE RONKONKOMA, NY
11779-2374

Practice Phone: 631-583-3333
Practice Fax:

1104810746 — DR. AARON KRAMER DDS
Practice Location Address:

516 HAWKINS AVE
LAKE RONKONKOMA, NY
11779-2374

Practice Phone: 631-588-9041
Practice Fax: 631-588-6772

1013194174 — PETER TAORMINO
Practice Location Address:

622 HAWKINS AVE , STE 8
LAKE RONKONKOMA, NY
11779-2374

Practice Phone: 631-467-2813
Practice Fax: 631-467-1417

1417504747 — MS. SARA DIANE TOLSON TSSLD
Practice Location Address:

622 HAWKINS AVE
LAKE RONKONKOMA, NY
11779-2374

Practice Phone: 631-240-3579
Practice Fax:

1902442197 — NICOLE MCLAUGHLIN
Practice Location Address:

622 HAWKINS AVE
LAKE RONKONKOMA, NY
11779-2374

Practice Phone: 631-240-3579
Practice Fax:

1649819392 — JESSICA RAE EBERHART M.S. CCC-SLP
Practice Location Address:

622 HAWKINS AVE
LAKE RONKONKOMA, NY
11779-2374

Practice Phone: 631-240-3579
Practice Fax:

Directions to “ ANTHONY PAVONE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.