Provider Demographics
NPI:1255768776
Name:RUBIANO, NATALIE (CCC-SLP TSSLD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:RUBIANO
Suffix:
Gender:F
Credentials:CCC-SLP TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 LENOX AVE
Mailing Address - Street 2:APT. 2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-3003
Mailing Address - Country:US
Mailing Address - Phone:914-574-3318
Mailing Address - Fax:
Practice Address - Street 1:470 LENOX AVE
Practice Address - Street 2:APT. 2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-3003
Practice Address - Country:US
Practice Address - Phone:914-574-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-29
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist