Provider Demographics
NPI:1164639258
Name:GOLFO, MARINA (TSSH)
Entity Type:Individual
Prefix:MS
First Name:MARINA
Middle Name:
Last Name:GOLFO
Suffix:
Gender:F
Credentials:TSSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 PELHAMDALE AVE
Mailing Address - Street 2:A1G
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-2951
Mailing Address - Country:US
Mailing Address - Phone:914-740-5031
Mailing Address - Fax:
Practice Address - Street 1:920 PELHAMDALE AVENUE
Practice Address - Street 2:A1G
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-2951
Practice Address - Country:US
Practice Address - Phone:914-740-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist