Provider Demographics
NPI:1932495348
Name:DEMARIA, CHRISTINE
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:
Last Name:DEMARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANNE
Other - Last Name:DEMARIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:800 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3012
Mailing Address - Country:US
Mailing Address - Phone:585-966-4266
Mailing Address - Fax:
Practice Address - Street 1:800 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3012
Practice Address - Country:US
Practice Address - Phone:585-966-4266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009987-1235Z00000X
NY0099871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist