Provider Demographics
NPI:1821226770
Name:COMPAGNONE, ANTHONY AVIANO (LIC SLP-CCC(BIL))
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:AVIANO
Last Name:COMPAGNONE
Suffix:
Gender:M
Credentials:LIC SLP-CCC(BIL)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6505
Mailing Address - Country:US
Mailing Address - Phone:718-984-9022
Mailing Address - Fax:718-967-2073
Practice Address - Street 1:4300 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6505
Practice Address - Country:US
Practice Address - Phone:718-984-9022
Practice Address - Fax:718-967-2073
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009472-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist