Provider Demographics
NPI:1578736070
Name:DIPIAZZA, CRISTEN L (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CRISTEN
Middle Name:L
Last Name:DIPIAZZA
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PADDOCK CT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2309
Mailing Address - Country:US
Mailing Address - Phone:718-986-4157
Mailing Address - Fax:
Practice Address - Street 1:10 PADDOCK CT
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-2309
Practice Address - Country:US
Practice Address - Phone:718-986-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018484235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist