Provider Demographics
NPI:1760708630
Name:DELMONICO, TERESA ANN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:DELMONICO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:DELMONICO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:700 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1444
Mailing Address - Country:US
Mailing Address - Phone:201-723-7359
Mailing Address - Fax:
Practice Address - Street 1:700 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1444
Practice Address - Country:US
Practice Address - Phone:201-723-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00093200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist