Provider Demographics
NPI:1033494398
Name:DISARO-HALILEJ, JOSIANE APARECIDA (CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOSIANE
Middle Name:APARECIDA
Last Name:DISARO-HALILEJ
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 EMORY RD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2363
Mailing Address - Country:US
Mailing Address - Phone:526-237-2546
Mailing Address - Fax:516-237-2508
Practice Address - Street 1:29 GERHARD RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-5501
Practice Address - Country:US
Practice Address - Phone:526-237-2546
Practice Address - Fax:516-237-2508
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009758-1235Z00000X, 251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist