Provider Demographics
NPI:1518484757
Name:MAGNO, ADRIANNA ROSE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ADRIANNA
Middle Name:ROSE
Last Name:MAGNO
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 1:4 CONKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2204
Mailing Address - Country:US
Mailing Address - Phone:631-681-4263
Mailing Address - Fax:
Practice Address - Street 1:49 WIRELESS BLVD STE 170
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3946
Practice Address - Country:US
Practice Address - Phone:631-869-4082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NY027199-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist