Provider Demographics
NPI:1760714067
Name:PASSERIEUX, DENISE M (AUD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:PASSERIEUX
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:HAIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:5528 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5044
Mailing Address - Country:US
Mailing Address - Phone:718-445-1312
Mailing Address - Fax:718-939-9877
Practice Address - Street 1:5528 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5044
Practice Address - Country:US
Practice Address - Phone:718-445-1312
Practice Address - Fax:718-939-9877
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001511231H00000X, 231HA2400X
NY14000005586237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter