Provider Demographics
NPI:1649553496
Name:MCGLONE, CATHERINE ANN
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
Last Name:MCGLONE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:VENEZIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 VINCENT PLACE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769-1707
Mailing Address - Country:US
Mailing Address - Phone:631-244-9430
Mailing Address - Fax:
Practice Address - Street 1:340 MILL RD
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2050
Practice Address - Country:US
Practice Address - Phone:631-288-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007607-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist