Provider Demographics
NPI:1740502947
Name:SEDITA, ROSSANA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ROSSANA
Middle Name:
Last Name:SEDITA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:ROSSANA
Other - Middle Name:
Other - Last Name:BONAVITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, SLP
Mailing Address - Street 1:483 KLONDIKE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6215
Mailing Address - Country:US
Mailing Address - Phone:718-288-4029
Mailing Address - Fax:
Practice Address - Street 1:348 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2216
Practice Address - Country:US
Practice Address - Phone:718-980-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019603235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist