Provider Demographics
NPI:1356693170
Name:CIPOLETTI, COURTNEY MICHELE
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:MICHELE
Last Name:CIPOLETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:MICHELE
Other - Last Name:HOCKING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1983 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2000
Mailing Address - Country:US
Mailing Address - Phone:516-686-4496
Mailing Address - Fax:516-497-7676
Practice Address - Street 1:350 E 146TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5702
Practice Address - Country:US
Practice Address - Phone:718-585-4494
Practice Address - Fax:718-585-3982
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3534352235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist