Provider Demographics
NPI:1730320029
Name:GASPARO, NICOLE CHRISTINE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:GASPARO
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 1:80 RUSTIC WAY
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9011
Mailing Address - Country:US
Mailing Address - Phone:732-409-1490
Mailing Address - Fax:
Practice Address - Street 1:80 RUSTIC WAY
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-9011
Practice Address - Country:US
Practice Address - Phone:732-409-1490
Practice Address - Fax:732-866-4305
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist