Provider Demographics
NPI:1942500228
Name:PUCCIARELLI, ROSE M (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:M
Last Name:PUCCIARELLI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:M
Other - Last Name:FALOTIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:232 BARLOW AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308
Mailing Address - Country:US
Mailing Address - Phone:718-984-1688
Mailing Address - Fax:
Practice Address - Street 1:232 BARLOW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308
Practice Address - Country:US
Practice Address - Phone:718-984-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist