Provider Demographics
NPI:1508372798
Name:CINTOLO, ATHENA
Entity Type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:CINTOLO
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 1:4414 NEWTOWN RD APT 4B
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2245
Mailing Address - Country:US
Mailing Address - Phone:917-792-1996
Mailing Address - Fax:
Practice Address - Street 1:4414 NEWTOWN RD APT 4B
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2245
Practice Address - Country:US
Practice Address - Phone:917-792-1996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-25
Last Update Date:2017-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist