Provider Demographics
NPI:1093850463
Name:CURTO, KELLY RAE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:RAE
Last Name:CURTO
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:RAE
Other - Last Name:POTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:247 E RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6826
Mailing Address - Country:US
Mailing Address - Phone:631-957-1923
Mailing Address - Fax:
Practice Address - Street 1:247 E RIVIERA DR
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-6826
Practice Address - Country:US
Practice Address - Phone:631-957-1923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013672-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist