Doctor Name: | SUSAN JEAN PERILLO |
NPI Number: | 1144305848 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 008633-1 |
Business Practice Address: | 650 Pre Emption Rd Geneva, NY - 144561334 |
Business Phone Number: | 3157897611 |
Business Fax Number: | 3157898136 |
Mailing Address: | 650 Pre Emption Rd, GENEVA |
State: | NY |
Postal Code: | 144561334 |
Phone Number: | 3157897611 |
Fax Number: | 3157898136 |
NPI Enumeration Date: | 10/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 008633-1 |
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 |