Provider Demographics
NPI:1043463177
Name:O'CONNELL, ELAINE JOYCE (MS)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:JOYCE
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:ELAINE
Other - Middle Name:JOYCE
Other - Last Name:OCONNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2034 MORROW AVE
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-4004
Mailing Address - Country:US
Mailing Address - Phone:518-233-0935
Mailing Address - Fax:
Practice Address - Street 1:597 3RD AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12182-2509
Practice Address - Country:US
Practice Address - Phone:518-233-0544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006482235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist