Provider Demographics
NPI:1851733752
Name:BERENATO, MARIA (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:BERENATO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NORTHERN BLVD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5338
Mailing Address - Country:US
Mailing Address - Phone:516-482-0660
Mailing Address - Fax:516-482-9131
Practice Address - Street 1:1000 NORTHERN BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5338
Practice Address - Country:US
Practice Address - Phone:516-482-0660
Practice Address - Fax:516-482-9131
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002495231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist