Provider Demographics
NPI:1336122753
Name:TRUNCALE, STEVEN J (MA CCC SLP TSHH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:TRUNCALE
Suffix:
Gender:M
Credentials:MA CCC SLP TSHH
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Mailing Address - Street 1:15 ELLSWORTH PL
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-5723
Mailing Address - Country:US
Mailing Address - Phone:631-889-1213
Mailing Address - Fax:631-462-0020
Practice Address - Street 1:423 CLAY PITTS RD
Practice Address - Street 2:BIRCHWOOD ASSISTED LIVING
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-3801
Practice Address - Country:US
Practice Address - Phone:631-889-1213
Practice Address - Fax:631-462-0020
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY012696235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02670506Medicaid