Provider Demographics
NPI:1760696827
Name:GIAMBALVO, BETTY D (MS, SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:D
Last Name:GIAMBALVO
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 CREEK RD.
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569
Mailing Address - Country:US
Mailing Address - Phone:845-635-2095
Mailing Address - Fax:845-635-2095
Practice Address - Street 1:400 W CUMMINGS PARK STE 3950
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6538
Practice Address - Country:US
Practice Address - Phone:845-313-9477
Practice Address - Fax:845-469-1878
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008980-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist