Doctor Name: | MR. MICHAEL JOHN NIESI |
NPI Number: | 1114161296 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA,CCC-SLP |
License Number: | 012117 |
Business Practice Address: | 49 Waimer Pl Staten Island, NY - 103124133 |
Business Phone Number: | 3478386849 |
Business Fax Number: | 3478386849 |
Mailing Address: | 49 Waimer Pl, STATEN ISLAND |
State: | NY |
Postal Code: | 103124133 |
Phone Number: | 3478386849 |
Fax Number: | 3478386849 |
NPI Enumeration Date: | 04/21/2009 |
NPI Last Update Date: | 09/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 012117 |
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 |