Provider Demographics
NPI:1033617436
Name:NEENAN, DAWN ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ELIZABETH
Last Name:NEENAN
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 140327
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-0327
Mailing Address - Country:US
Mailing Address - Phone:516-998-6473
Mailing Address - Fax:
Practice Address - Street 1:1110 SOUTH AVE STE 405
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3411
Practice Address - Country:US
Practice Address - Phone:516-998-6473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027118-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist