Provider Demographics
NPI:1477957306
Name:CAPORUSCIO, MAUREEN (MA,CCC,TSHH)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:CAPORUSCIO
Suffix:
Gender:F
Credentials:MA,CCC,TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 CLAY PITTS RD
Mailing Address - Street 2:
Mailing Address - City:E NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-3822
Mailing Address - Country:US
Mailing Address - Phone:631-858-3680
Mailing Address - Fax:
Practice Address - Street 1:480 CLAY PITTS RD
Practice Address - Street 2:
Practice Address - City:E NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-3822
Practice Address - Country:US
Practice Address - Phone:631-858-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist