Provider Demographics
NPI:1093952343
Name:FENICE, MELISSA ANN (MA CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:ANN
Last Name:FENICE
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 1:237 E 28TH ST
Mailing Address - Street 2:#3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:516-459-3474
Mailing Address - Fax:
Practice Address - Street 1:237 E 28TH ST
Practice Address - Street 2:#3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:516-459-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist