Provider Demographics
NPI:1639433139
Name:DEPALMA, NICOLE M (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:DEPALMA
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 1:344 E 16TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3815
Mailing Address - Country:US
Mailing Address - Phone:845-304-6304
Mailing Address - Fax:
Practice Address - Street 1:12 LAUREL DR
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2204
Practice Address - Country:US
Practice Address - Phone:845-304-6304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17527235Z00000X
NY022646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist