Provider Demographics
NPI:1942725239
Name:PABLO, PRISCILLA CLAUDIA ALBANO
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:CLAUDIA ALBANO
Last Name:PABLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1906
Mailing Address - Country:US
Mailing Address - Phone:718-442-8588
Mailing Address - Fax:718-442-6737
Practice Address - Street 1:285 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1906
Practice Address - Country:US
Practice Address - Phone:718-442-8588
Practice Address - Fax:718-442-6737
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026453-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty