Doctor Name: | MISS TRACY LYNN MASSARO |
NPI Number: | 1033406863 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. S.L.P. T.S.L.D. |
License Number: | 021063-1 |
Business Practice Address: | 1767 Veterans Hwy Ste 22 Islandia, NY - 117491536 |
Business Phone Number: | 6318519486 |
Business Fax Number: | 6318519487 |
Mailing Address: | 923 N Erie Ave, LINDENHURST |
State: | NY |
Postal Code: | 117572116 |
Phone Number: | 6317486992 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2011 |
NPI Last Update Date: | 06/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 021063-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |