Individual
ANITA THANNICKAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5740 MARATHON PKWY, LITTLE NECK, NY 11362-2036
(718) 423-8825
Mailing address
5740 MARATHON PKWY, LITTLE NECK, NY 11362-2036
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015444
NY
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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