Provider Demographics
NPI:1992214332
Name:PIPOLI, DANIELLA M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:M
Last Name:PIPOLI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 HIDDEN CT
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1946
Mailing Address - Country:US
Mailing Address - Phone:732-320-1756
Mailing Address - Fax:
Practice Address - Street 1:240 W 113TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-3306
Practice Address - Country:US
Practice Address - Phone:732-320-1756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist