Provider Demographics
NPI:1346713005
Name:JUNTURA, KRISTINE ALYSSA
Entity Type:Individual
Prefix:MISS
First Name:KRISTINE
Middle Name:ALYSSA
Last Name:JUNTURA
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 1:56 JOLINE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-2019
Mailing Address - Country:US
Mailing Address - Phone:347-653-8047
Mailing Address - Fax:
Practice Address - Street 1:DAVID P INZERILLO SPEECH LANGUAGE PATHOLOGY P.C.
Practice Address - Street 2:157 SENATOR STREET
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-551-8307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027020235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist