Provider Demographics
NPI:1295049765
Name:ERRICO, ROSA ANA (MS,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ROSA
Middle Name:ANA
Last Name:ERRICO
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MRS
Other - First Name:ROSA
Other - Middle Name:ANA
Other - Last Name:ERRICO-LANDAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:465 GRAND ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:37 HAWTHORNE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-1006
Practice Address - Country:US
Practice Address - Phone:347-404-4147
Practice Address - Fax:347-404-4147
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019937235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist