Individual
ANISIO DEOLIVEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
2901 216TH ST, BAYSIDE, NY 11360-2810
(718) 281-8800
Mailing address
78 MAGAZINE ST, AP#2, NEWARK, NJ 07105-3476
(917) 770-3674
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
017335
NY
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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