Provider Demographics
NPI:1083869507
Name:BARONE, LISA (MA)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:BARONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MONROE BLVD
Mailing Address - Street 2:APT. 3S
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4343
Mailing Address - Country:US
Mailing Address - Phone:516-665-8754
Mailing Address - Fax:
Practice Address - Street 1:10 MONROE BLVD
Practice Address - Street 2:APT. 3S
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4343
Practice Address - Country:US
Practice Address - Phone:516-665-8754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014432-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist