Provider Demographics
NPI:1750536835
Name:VELLA, BARBARA (CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:VELLA
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROOSEVELT AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3064
Mailing Address - Country:US
Mailing Address - Phone:516-496-4460
Mailing Address - Fax:516-921-4432
Practice Address - Street 1:2 ROOSEVELT AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3064
Practice Address - Country:US
Practice Address - Phone:516-496-4460
Practice Address - Fax:516-921-4432
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004102-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist