Provider Demographics
NPI:1790552651
Name:CECILIA VELLOZO SPEECH LANGUAGE PATHOLOGIST PLLC
Entity Type:Organization
Organization Name:CECILIA VELLOZO SPEECH LANGUAGE PATHOLOGIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELLOZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-409-8967
Mailing Address - Street 1:178 OCEAN PKWY APT E7
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2454
Mailing Address - Country:US
Mailing Address - Phone:917-409-8967
Mailing Address - Fax:
Practice Address - Street 1:178 OCEAN PKWY APT E7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2454
Practice Address - Country:US
Practice Address - Phone:917-409-8967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty