Provider Demographics
NPI:1326822099
Name:DIGREGORIO, BROOKE ALYSSA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ALYSSA
Last Name:DIGREGORIO
Suffix:
Gender:F
Credentials: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 1:15 VIC PASS
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3848
Mailing Address - Country:US
Mailing Address - Phone:845-531-8377
Mailing Address - Fax:
Practice Address - Street 1:2951 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2596
Practice Address - Country:US
Practice Address - Phone:718-822-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist