Provider Demographics
NPI:1134669443
Name:MONZILLO, MARIA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MONZILLO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-2134
Mailing Address - Country:US
Mailing Address - Phone:347-659-7479
Mailing Address - Fax:
Practice Address - Street 1:113 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1148
Practice Address - Country:US
Practice Address - Phone:347-659-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist