Provider Demographics
NPI:1629356316
Name:CARLINO DIAZ, MELISSA (MA, CCC -A)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:CARLINO DIAZ
Suffix:
Gender:F
Credentials:MA, CCC -A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 PARSONS BLVD
Mailing Address - Street 2:AUDIOLOGY DEPARTMENT, RM 2018 FLUSHING HOSPITAL
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-670-5911
Mailing Address - Fax:718-670-4453
Practice Address - Street 1:4500 PARSONS BLVD
Practice Address - Street 2:AUDIOLOGY DEPARTMENT, RM 2018 FLUSHING HOSPITAL
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-5911
Practice Address - Fax:718-670-4453
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1630231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist