Provider Demographics
NPI:1881849974
Name:PAGANO PIACENTE, GERALDINE (SLP)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:
Last Name:PAGANO PIACENTE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3433
Mailing Address - Country:US
Mailing Address - Phone:516-308-3954
Mailing Address - Fax:
Practice Address - Street 1:1836 BEECH ST
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3433
Practice Address - Country:US
Practice Address - Phone:516-679-5574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3266-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist