Provider Demographics
NPI:1265849731
Name:VESSIO, ELISSA RACHEL (MS)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:RACHEL
Last Name:VESSIO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6736 KESSEL ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4143
Mailing Address - Country:US
Mailing Address - Phone:917-587-0950
Mailing Address - Fax:
Practice Address - Street 1:6736 KESSEL ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4143
Practice Address - Country:US
Practice Address - Phone:917-587-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist