Provider Demographics
NPI:1225621360
Name:OBRIEN, ANNIEROSE (SLP)
Entity Type:Individual
Prefix:
First Name:ANNIEROSE
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FLORENCE PL
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-3305
Mailing Address - Country:US
Mailing Address - Phone:631-681-7060
Mailing Address - Fax:
Practice Address - Street 1:52 3RD AVE # 11717
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-6198
Practice Address - Country:US
Practice Address - Phone:631-434-2583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist