Provider Demographics
NPI:1811318165
Name:TASSONE-LOGATTO, RACHEL A (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:TASSONE-LOGATTO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 N COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-3065
Mailing Address - Country:US
Mailing Address - Phone:631-285-8600
Mailing Address - Fax:
Practice Address - Street 1:8 43RD ST
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-2325
Practice Address - Country:US
Practice Address - Phone:631-285-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008472-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist