Provider Demographics
NPI:1376977843
Name:ELEMBABY-ANNUNZIATO, MARWA I (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARWA
Middle Name:I
Last Name:ELEMBABY-ANNUNZIATO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1516
Mailing Address - Country:US
Mailing Address - Phone:631-335-2967
Mailing Address - Fax:
Practice Address - Street 1:204 ALLEN AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1516
Practice Address - Country:US
Practice Address - Phone:631-335-2967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-02
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program