Provider Demographics
NPI:1124263934
Name:ROSS, RHONDA SHERI (SLP)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:SHERI
Last Name:ROSS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BANGOR ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6202
Mailing Address - Country:US
Mailing Address - Phone:917-620-4202
Mailing Address - Fax:718-494-7715
Practice Address - Street 1:24 BANGOR ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6202
Practice Address - Country:US
Practice Address - Phone:917-620-4202
Practice Address - Fax:718-494-7715
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011817-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist