Provider Demographics
NPI:1063665933
Name:AIEZZA, BRIENNE ELIZABETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIENNE
Middle Name:ELIZABETH
Last Name:AIEZZA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRADHURST AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2135
Mailing Address - Country:US
Mailing Address - Phone:914-592-8526
Mailing Address - Fax:
Practice Address - Street 1:5 BRADHURST AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2135
Practice Address - Country:US
Practice Address - Phone:914-592-8526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-018335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist