Provider Demographics
NPI:1679242697
Name:COLONNA, LORENZA TERESA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LORENZA
Middle Name:TERESA
Last Name:COLONNA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 MAINE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-2263
Mailing Address - Country:US
Mailing Address - Phone:718-759-7707
Mailing Address - Fax:
Practice Address - Street 1:3297 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6730
Practice Address - Country:US
Practice Address - Phone:718-759-7707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist