Provider Demographics
NPI:1497182141
Name:VIGGIANO, LYNN (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:VIGGIANO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 N BROADWAY
Mailing Address - Street 2:APT. J2
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1240
Mailing Address - Country:US
Mailing Address - Phone:845-942-3000
Mailing Address - Fax:
Practice Address - Street 1:65 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1238
Practice Address - Country:US
Practice Address - Phone:845-942-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist