Provider Demographics
NPI:1467666552
Name:VECCHIO, ALEXIS MARIA (MA CCCSLP)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:MARIA
Last Name:VECCHIO
Suffix:
Gender:F
Credentials:MA CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ERIE STREET
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2707
Mailing Address - Country:US
Mailing Address - Phone:718-967-4240
Mailing Address - Fax:718-967-4240
Practice Address - Street 1:18 ERIE STREET
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2707
Practice Address - Country:US
Practice Address - Phone:917-575-8706
Practice Address - Fax:718-967-4240
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015901SPEECHPATHOLOG235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist