Provider Demographics
NPI:1932245412
Name:GIGLIO-MCCABE, BRENDA L (SLP)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:L
Last Name:GIGLIO-MCCABE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 ANNUSKEMUNNICA RD
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4424
Mailing Address - Country:US
Mailing Address - Phone:631-422-2156
Mailing Address - Fax:631-422-2158
Practice Address - Street 1:165 ANNUSKEMUNNICA RD
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-4424
Practice Address - Country:US
Practice Address - Phone:631-422-2156
Practice Address - Fax:631-422-2158
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011405-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist