Provider Demographics
NPI:1275877136
Name:CHRISTINE FERRERI SLP PC
Entity Type:Organization
Organization Name:CHRISTINE FERRERI SLP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:FERRERI
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:631-376-9146
Mailing Address - Street 1:1115 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-1621
Mailing Address - Country:US
Mailing Address - Phone:631-376-9146
Mailing Address - Fax:631-376-9146
Practice Address - Street 1:1115 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-1621
Practice Address - Country:US
Practice Address - Phone:631-376-9146
Practice Address - Fax:631-376-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0069221252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency