Provider Demographics
NPI:1558638932
Name:DROMGOOLE, ANNMARIE KNOERL
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:KNOERL
Last Name:DROMGOOLE
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 1:5122 BLACKEYED SUSAN PATH
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:NY
Mailing Address - Zip Code:13041-8900
Mailing Address - Country:US
Mailing Address - Phone:315-699-4159
Mailing Address - Fax:
Practice Address - Street 1:5122 BLACKEYED SUSAN PATH
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:NY
Practice Address - Zip Code:13041-8900
Practice Address - Country:US
Practice Address - Phone:315-699-4159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006045-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist