Provider Demographics
NPI:1346525177
Name:FERREYRA SOLARI DE RIVERA, MILAGRITOS SUSANA
Entity Type:Individual
Prefix:
First Name:MILAGRITOS
Middle Name:SUSANA
Last Name:FERREYRA SOLARI DE RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 LEXINGTON AVE
Mailing Address - Street 2:FL 1
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-2830
Mailing Address - Country:US
Mailing Address - Phone:516-491-2082
Mailing Address - Fax:
Practice Address - Street 1:42 LEXINGTON AVE
Practice Address - Street 2:FL 1
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-2830
Practice Address - Country:US
Practice Address - Phone:516-491-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019549-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist