Provider Demographics
NPI:1407443302
Name:DELAROSA, BRIGITTE S (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:S
Last Name:DELAROSA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RIVERDALE AVE APT 5A
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-3640
Mailing Address - Country:US
Mailing Address - Phone:914-433-9116
Mailing Address - Fax:
Practice Address - Street 1:535 UNION AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4649
Practice Address - Country:US
Practice Address - Phone:718-292-4120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-26
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty