Provider Demographics
NPI:1952076002
Name:CINTRON, SAMANTHA K (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:K
Last Name:CINTRON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SUNRISE PL
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-2033
Mailing Address - Country:US
Mailing Address - Phone:516-780-1854
Mailing Address - Fax:
Practice Address - Street 1:1428 5TH AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-4153
Practice Address - Country:US
Practice Address - Phone:631-665-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist