Provider Demographics
NPI:1629402151
Name:DENICOLA, BARBARA C (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:C
Last Name:DENICOLA
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WESTON ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4031
Mailing Address - Country:US
Mailing Address - Phone:631-812-3400
Mailing Address - Fax:
Practice Address - Street 1:19 SCHOOL LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-2897
Practice Address - Country:US
Practice Address - Phone:631-812-3421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004873-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist