Provider Demographics
NPI:1497371017
Name:POZO, MADELINE G
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:G
Last Name:POZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 ECHO PL APT 6E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5343
Mailing Address - Country:US
Mailing Address - Phone:347-272-4397
Mailing Address - Fax:
Practice Address - Street 1:240 ECHO PL APT 6E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5343
Practice Address - Country:US
Practice Address - Phone:347-272-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist