Provider Demographics
NPI:1568744274
Name:STELLUTI, LINDA MARIE (SLP-CCC-TSHH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:STELLUTI
Suffix:
Gender:F
Credentials:SLP-CCC-TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2828
Mailing Address - Country:US
Mailing Address - Phone:914-949-3490
Mailing Address - Fax:914-949-3490
Practice Address - Street 1:40 OLIVIA ST
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-4802
Practice Address - Country:US
Practice Address - Phone:914-934-7991
Practice Address - Fax:914-934-7991
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0128881235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0128881OtherSPEECH PATHOLOGIST