Provider Demographics
NPI:1225362478
Name:ZANFORDINO, JOSEPH PETER (MA CCC/SP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PETER
Last Name:ZANFORDINO
Suffix:
Gender:M
Credentials:MA CCC/SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5531
Mailing Address - Country:US
Mailing Address - Phone:607-227-0143
Mailing Address - Fax:
Practice Address - Street 1:213 WOOD ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5531
Practice Address - Country:US
Practice Address - Phone:607-227-0143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003676-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist