Doctor Name: | MS. MARISSA GORDETSKY LOBOSCO |
NPI Number: | 1043580376 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP TSSLD |
License Number: | 021543-1 |
Business Practice Address: | 60 Madison Ave Fl 8 New York, NY - 100101676 |
Business Phone Number: | 2126840099 |
Business Fax Number: | |
Mailing Address: | 2 Domessina Ln Apt D7, CALDWELL |
State: | NJ |
Postal Code: | 070064854 |
Phone Number: | 9173558343 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2012 |
NPI Last Update Date: | 01/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 021543-1 |
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 |