Provider Demographics
NPI:1982914784
Name:ESCOTT, CRISTINA MARIA
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:MARIA
Last Name:ESCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 OLD FORESTBURGH ROAD
Mailing Address - Street 2:
Mailing Address - City:SPARROW BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12780
Mailing Address - Country:US
Mailing Address - Phone:845-856-4967
Mailing Address - Fax:
Practice Address - Street 1:74 OLD FORESTBURG ROAD
Practice Address - Street 2:
Practice Address - City:SPARROW BUSH
Practice Address - State:NY
Practice Address - Zip Code:12780
Practice Address - Country:US
Practice Address - Phone:845-856-4967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010830-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist