Provider Demographics
NPI:1578872040
Name:CAFALDO, ASHLEY MARIE (MSED CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:MARIE
Last Name:CAFALDO
Suffix:
Gender:F
Credentials:MSED 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:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:GLASCO
Mailing Address - State:NY
Mailing Address - Zip Code:12432-0531
Mailing Address - Country:US
Mailing Address - Phone:845-750-9890
Mailing Address - Fax:
Practice Address - Street 1:211 E UNION ST
Practice Address - Street 2:#2
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5611
Practice Address - Country:US
Practice Address - Phone:845-750-9890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020477-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03606535Medicaid