Provider Demographics
NPI:1407216658
Name:CARBONE, CATHERINE M (MS, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:CARBONE
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3051
Mailing Address - Country:US
Mailing Address - Phone:631-387-2618
Mailing Address - Fax:
Practice Address - Street 1:10 MAPLE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3051
Practice Address - Country:US
Practice Address - Phone:631-387-2618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0217881235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist