Provider Demographics
NPI:1467712547
Name:PIACENTINI, MARIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:
Last Name:PIACENTINI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 KNOLLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1321
Mailing Address - Country:US
Mailing Address - Phone:516-365-2711
Mailing Address - Fax:516-944-3032
Practice Address - Street 1:79 KNOLLWOOD RD
Practice Address - Street 2:ROSLYN
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1321
Practice Address - Country:US
Practice Address - Phone:516-365-2711
Practice Address - Fax:516-944-3032
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009906235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist