Provider Demographics
NPI:1639633308
Name:ALESSANDRO, NOELLA (MS)
Entity Type:Individual
Prefix:MS
First Name:NOELLA
Middle Name:
Last Name:ALESSANDRO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15050 14TH RD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2609
Mailing Address - Country:US
Mailing Address - Phone:718-767-0091
Mailing Address - Fax:718-767-0086
Practice Address - Street 1:150-50 14TH ROAD
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357
Practice Address - Country:US
Practice Address - Phone:718-767-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1128825235Z00000X
CT03-837223235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06122678Medicaid