Provider Demographics
NPI:1649675976
Name:CACCIAPAGLIA, ALICIA (MA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:CACCIAPAGLIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:O'LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2650 GREAT NECK RD
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-1600
Mailing Address - Country:US
Mailing Address - Phone:631-842-4015
Mailing Address - Fax:
Practice Address - Street 1:399 CONKLIN ST
Practice Address - Street 2:SUITE 303
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-2614
Practice Address - Country:US
Practice Address - Phone:516-249-5477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist