Provider Demographics
NPI:1588033377
Name:CESCHINI, CORISSA N (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CORISSA
Middle Name:N
Last Name:CESCHINI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CORISSA
Other - Middle Name:N
Other - Last Name:TIMPONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:9 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4715
Mailing Address - Country:US
Mailing Address - Phone:631-356-0944
Mailing Address - Fax:
Practice Address - Street 1:12 DON LN
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-356-0944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026067-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist