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Organization
MARY DACIERNO SPEECH LANGUAGE PATHOLOGIST PC
Active
Organization
MARY DACIERNO SPEECH LANGUAGE PATHOLOGIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY VITALE M.S. CCC SLP (SPEECH LANGUAGE PATHOLOGIST)
(917) 586-2964
Entity
Organization
Contact information
Practice address
52 ROMAN AVE, APT. 4, STATEN ISLAND, NY 10314-2721
(917) 586-2964
Mailing address
52 ROMAN AVE, APT. 4, STATEN ISLAND, NY 10314-2721
(917) 586-2964
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
022956
NY
Other
Enumeration date
04/07/2014
Last updated
12/02/2016
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