Provider Demographics
NPI:1447400569
Name:CONSTANTE, PEGGY C (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:C
Last Name:CONSTANTE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1166 ELDER AVE
Mailing Address - Street 2:APT 2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-3501
Mailing Address - Country:US
Mailing Address - Phone:718-620-3770
Mailing Address - Fax:
Practice Address - Street 1:317 NORTH ST
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2209
Practice Address - Country:US
Practice Address - Phone:914-597-4081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014443-0235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist