Provider Demographics
NPI:1346493301
Name:GIFTOS AND MAZZONE, CO.,INC.
Entity Type:Organization
Organization Name:GIFTOS AND MAZZONE, CO.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:MAZZONE
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:518-361-1022
Mailing Address - Street 1:519 NATHANIEL DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5652
Mailing Address - Country:US
Mailing Address - Phone:518-361-1022
Mailing Address - Fax:866-788-7140
Practice Address - Street 1:519 NATHANIEL DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5652
Practice Address - Country:US
Practice Address - Phone:518-361-1022
Practice Address - Fax:866-788-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004188-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency