Provider Demographics
NPI:1417307463
Name:DE MARINIS, ALICIA
Entity Type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:
Last Name:DE MARINIS
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 1:84 LUQUER RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1016
Mailing Address - Country:US
Mailing Address - Phone:516-581-5759
Mailing Address - Fax:
Practice Address - Street 1:134 W 26TH ST
Practice Address - Street 2:SUITE #602
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6803
Practice Address - Country:US
Practice Address - Phone:212-606-9306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist