Provider Demographics
NPI:1790221281
Name:PINNOLA, VANESSA RAE (AUD)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:RAE
Last Name:PINNOLA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:VANESSA
Other - Middle Name:RAE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:241 NORTH ROAD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-431-8800
Mailing Address - Fax:845-483-5675
Practice Address - Street 1:115 DELAFIELD STREET
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-431-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist