Provider Demographics
NPI:1063679298
Name:ZINGARO DASCOLI, JAN M (MS, CCC/NYS LIC SLP)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:M
Last Name:ZINGARO DASCOLI
Suffix:
Gender:F
Credentials:MS, CCC/NYS LIC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 CORIANDER CT
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1265
Mailing Address - Country:US
Mailing Address - Phone:716-689-2066
Mailing Address - Fax:
Practice Address - Street 1:86 CORIANDER CT
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1265
Practice Address - Country:US
Practice Address - Phone:716-689-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003493235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist