Provider Demographics
NPI:1689985673
Name:REMINGTON, MARY ANN (MARY ANN REMINGTON)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:MARY ANN REMINGTON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CANVASBACK RDG
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12188-1042
Mailing Address - Country:US
Mailing Address - Phone:518-233-7823
Mailing Address - Fax:
Practice Address - Street 1:1979 CENTRAL AVE.
Practice Address - Street 2:MAYWOOD SCHOOL
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:518-233-7823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005493-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist