Provider Demographics
NPI:1952701591
Name:GAETANI, LAUREN (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GAETANI
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 RHODE ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4146
Mailing Address - Country:US
Mailing Address - Phone:516-395-4827
Mailing Address - Fax:
Practice Address - Street 1:6 LENORE AVE
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5929
Practice Address - Country:US
Practice Address - Phone:631-425-0656
Practice Address - Fax:631-350-7104
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist