Provider Demographics
NPI:1760749527
Name:BRITO, LOLA FERNANDA
Entity Type:Individual
Prefix:MISS
First Name:LOLA
Middle Name:FERNANDA
Last Name:BRITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 DAVENPORT AVE
Mailing Address - Street 2:3 E
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3450
Mailing Address - Country:US
Mailing Address - Phone:914-468-5304
Mailing Address - Fax:
Practice Address - Street 1:39 DAVENPORT AVE
Practice Address - Street 2:3 E
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-3450
Practice Address - Country:US
Practice Address - Phone:914-468-5304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist