Provider Demographics
NPI:1275832966
Name:TORNATORE, ANDREA A (MS, CCC/A)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:A
Last Name:TORNATORE
Suffix:
Gender:F
Credentials:MS, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:561-478-8770
Mailing Address - Fax:561-688-8877
Practice Address - Street 1:500 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3421
Practice Address - Country:US
Practice Address - Phone:718-982-9270
Practice Address - Fax:718-982-8474
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001477-1231H00000X
NJ41YA00040600231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist