Provider Demographics
NPI:1912613290
Name:SENO, MARYROSE (SPEECH THERAPIST)
Entity Type:Individual
Prefix:
First Name:MARYROSE
Middle Name:
Last Name:SENO
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:MARYROSE
Other - Middle Name:CABATO
Other - Last Name:SENO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SPEECH THERAPIST
Mailing Address - Street 1:7289 CALAMUS AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7635
Mailing Address - Country:US
Mailing Address - Phone:347-476-1372
Mailing Address - Fax:
Practice Address - Street 1:3252 37TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-4004
Practice Address - Country:US
Practice Address - Phone:718-316-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034013-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist