Provider Demographics
NPI:1598452120
Name:PETTI, CRISTINA ROSE
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ROSE
Last Name:PETTI
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 1:24 TRAPPING WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2520
Mailing Address - Country:US
Mailing Address - Phone:914-924-0078
Mailing Address - Fax:
Practice Address - Street 1:8801 19TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4684
Practice Address - Country:US
Practice Address - Phone:888-806-2497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist