Individual
AIDA COLLAGUAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 AMBER LANE, OYSTER BAY, NY 11771-3115
(347) 270-8850
(888) 634-3483
Mailing address
4114 50TH ST, WOODSIDE, NY 11377-4346
(347) 417-6631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
NY
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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