Provider Demographics
NPI:1497984371
Name:CONNAIRE, PATRICIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:CONNAIRE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:EDGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:38 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5211
Mailing Address - Country:US
Mailing Address - Phone:914-602-9443
Mailing Address - Fax:914-713-4485
Practice Address - Street 1:4300 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6505
Practice Address - Country:US
Practice Address - Phone:718-984-9022
Practice Address - Fax:718-967-2073
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist