Provider Demographics
NPI:1689298127
Name:ROMANO, ALISSA MARIE (MS, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:MARIE
Last Name:ROMANO
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:MARIE
Other - Last Name:GIANNOTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP, TSSLD
Mailing Address - Street 1:71 BERGMAN DR
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1403
Mailing Address - Country:US
Mailing Address - Phone:516-603-7596
Mailing Address - Fax:
Practice Address - Street 1:100 BANKS AVE APT 1257
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-6209
Practice Address - Country:US
Practice Address - Phone:516-603-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031657235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist