Provider Demographics
NPI:1174796932
Name:URBINA, MARIANA CONSUELO (AUD)
Entity type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:CONSUELO
Last Name:URBINA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 BAINBRIDGE AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2404
Mailing Address - Country:US
Mailing Address - Phone:718-920-2333
Mailing Address - Fax:718-882-7675
Practice Address - Street 1:3400 BAINBRIDGE AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2404
Practice Address - Country:US
Practice Address - Phone:718-920-2333
Practice Address - Fax:718-882-7675
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000693-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist