Provider Demographics
NPI:1801171087
Name:CERNIGLIA, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CERNIGLIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 VISCHER FERRY RD
Mailing Address - Street 2:
Mailing Address - City:REXFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12148-1617
Mailing Address - Country:US
Mailing Address - Phone:518-475-6675
Mailing Address - Fax:
Practice Address - Street 1:65 TREMONT ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3529
Practice Address - Country:US
Practice Address - Phone:518-475-6675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011199-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist