Provider Demographics
NPI:1508170762
Name:MONEGRO, LORILET (MS, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:LORILET
Middle Name:
Last Name:MONEGRO
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 RESERVOIR OVAL E
Mailing Address - Street 2:SUITE 5D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3110
Mailing Address - Country:US
Mailing Address - Phone:646-226-9958
Mailing Address - Fax:
Practice Address - Street 1:3320 RESERVOIR OVAL E
Practice Address - Street 2:SUITE 5D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3110
Practice Address - Country:US
Practice Address - Phone:646-226-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0167764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist