Provider Demographics
NPI:1811219298
Name:SANTALONE-CERTA, MARIANNE (MA, CCC-SP)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:SANTALONE-CERTA
Suffix:
Gender:F
Credentials:MA, CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CLOISTER ST
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-1025
Mailing Address - Country:US
Mailing Address - Phone:516-984-0866
Mailing Address - Fax:718-960-9479
Practice Address - Street 1:4487 3RD AVE
Practice Address - Street 2:ST BARNABAS HOSPITAL, 2ND FLR. SPEECH & HEARING
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1526
Practice Address - Country:US
Practice Address - Phone:718-960-6646
Practice Address - Fax:718-960-9479
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58003217235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist