Provider Demographics
NPI:1518584804
Name:PORCELLA, ELIZABETH LEE
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LEE
Last Name:PORCELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LEE
Other - Last Name:LINDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5916
Mailing Address - Country:US
Mailing Address - Phone:914-806-8741
Mailing Address - Fax:
Practice Address - Street 1:350 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5916
Practice Address - Country:US
Practice Address - Phone:718-645-2862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NY032167235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist