Provider Demographics
NPI:1578849873
Name:COMPETELLO, BRIDGET MARIE
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:MARIE
Last Name:COMPETELLO
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 1:16635 9TH AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2021
Mailing Address - Country:US
Mailing Address - Phone:646-996-5057
Mailing Address - Fax:
Practice Address - Street 1:2 LARCH AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2352
Practice Address - Country:US
Practice Address - Phone:516-327-9307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020188235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist