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NPI Code Detail

MEDICARE: MS. ROSE L. ATENIESE M.S., CCC-SLP, TSSLD

MEDICARE:  MS. ROSE L. ATENIESE  M.S., CCC-SLP, TSSLD
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
1235Z00000XSpeech-Language Pathologist019537-1NY

General Provider Information

NPI Number : 1750683157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSE L. ATENIESE M.S., CCC-SLP, TSSLD
Provider Business Mailing Address
First Line : 25 ROUTE 111 UNIT 971
Second Line :
City : SMITHTOWN
State : NY
Zip : 11787-7039
Country : US
Telephone Number : 516-410-5112
Fax Number :
Provider Business Practice Location Address
First Line : 2025 74TH STREET
Second Line :
City : BROOKYLN
State : NY
Zip : 11204
Country : US
Telephone Number : 516-410-5112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2010
Last Update Date : 10/15/2020

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Directions to “ MS. ROSE L. ATENIESE M.S., CCC-SLP, TSSLD” Practice Location

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