Provider Demographics
NPI:1801252911
Name:MASCIANDARO, NATALEE AMBROZE (MA, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:NATALEE
Middle Name:AMBROZE
Last Name:MASCIANDARO
Suffix:
Gender:
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-3167
Mailing Address - Country:US
Mailing Address - Phone:631-487-8831
Mailing Address - Fax:
Practice Address - Street 1:158 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-3167
Practice Address - Country:US
Practice Address - Phone:631-669-7098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist