Provider Demographics
NPI:1881958445
Name:MARANGA, GINA (MS,CCC-SP)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:MARANGA
Suffix:
Gender:F
Credentials:MS,CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1901
Mailing Address - Country:US
Mailing Address - Phone:917-523-4372
Mailing Address - Fax:718-745-6129
Practice Address - Street 1:97 72ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1901
Practice Address - Country:US
Practice Address - Phone:917-523-4372
Practice Address - Fax:718-745-6129
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004704235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist