Provider Demographics
NPI:1689814006
Name:DEPAOLA, CHRISTINA F (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:F
Last Name:DEPAOLA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 TOTTENHAM PL
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3516
Mailing Address - Country:US
Mailing Address - Phone:718-309-6574
Mailing Address - Fax:
Practice Address - Street 1:C/O 25 TOTTENHAM PLACE (NO BUSINESS DONE AT ADDRESS)
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-309-6574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011872235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist