Provider Demographics
NPI:1326409657
Name:MONTELEONE, ALYSSA MARGARET (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARGARET
Last Name:MONTELEONE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MILLFORD LN
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-2828
Mailing Address - Country:US
Mailing Address - Phone:631-504-2980
Mailing Address - Fax:
Practice Address - Street 1:42 MILLFORD LN
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-2828
Practice Address - Country:US
Practice Address - Phone:631-504-2980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025486-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist