Provider Demographics
NPI:1700198322
Name:MALONEY, KRYSTI (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTI
Middle Name:
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 MAHOGANY RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9301
Mailing Address - Country:US
Mailing Address - Phone:631-804-3642
Mailing Address - Fax:
Practice Address - Street 1:53 MAHOGANY RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9301
Practice Address - Country:US
Practice Address - Phone:631-804-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020085-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist