Individual
MRS. CARMEN ELENA FANTAUZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. C.C.C.-SLP
Contact information
Practice address
6107 75TH PL, MIDDLE VILLAGE, NY 11379-1219
(646) 234-3744
Mailing address
6107 75TH PL, MIDDLE VILLAGE, NY 11379-1219
(646) 234-3744
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
018482-1
NY
Other
Enumeration date
11/10/2008
Last updated
01/05/2010
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