Provider Demographics
NPI:1558419903
Name:BOYLE-PASCUCCI, MARISA LEIGH (AUD,CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:LEIGH
Last Name:BOYLE-PASCUCCI
Suffix:
Gender:F
Credentials:AUD,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:140 LOCKWOOD AVE STE 202
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4908
Mailing Address - Country:US
Mailing Address - Phone:914-576-6150
Mailing Address - Fax:914-576-6037
Practice Address - Street 1:140 LOCKWOOD AVE STE 202
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4908
Practice Address - Country:US
Practice Address - Phone:914-576-6150
Practice Address - Fax:914-576-6037
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11713-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
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NYM7224OtherEMPIRE BCBS
NY6995139-003OtherCIGNA