Provider Demographics
NPI:1265149694
Name:CHIRCO, ANGELICA ROSE
Entity type:Individual
Prefix:MS
First Name:ANGELICA
Middle Name:ROSE
Last Name:CHIRCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 PARK ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-1812
Mailing Address - Country:US
Mailing Address - Phone:347-439-7612
Mailing Address - Fax:
Practice Address - Street 1:2955 VETERANS RD W
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2515
Practice Address - Country:US
Practice Address - Phone:347-896-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist