Provider Demographics
NPI:1245739317
Name:MAGLIULO, CHRISTINA ALLYSE (BA, MS, CCC, SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ALLYSE
Last Name:MAGLIULO
Suffix:
Gender:F
Credentials:BA, MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2917
Mailing Address - Country:US
Mailing Address - Phone:917-470-2850
Mailing Address - Fax:
Practice Address - Street 1:98 GRANT ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3235
Practice Address - Country:US
Practice Address - Phone:718-981-5034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025303-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist