Angela Grant-Cerasaro, MS, CCC, SLP
Individual provider Active NPI Speech-Language Pathologist · King Ferry, NY
NPI 1306111455 · NPPES record last updated Mar 21, 2012
Key facts
- NPI
- 1306111455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 019054-1 (NY)
- Practice address
- 8842 State Route 90 N
King Ferry, NY 13081-8717 - Phone
- (315) 364-7570
- Fax
- (315) 364-8016
- NPI assigned
- Mar 21, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019054-1 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 019054-1 | NY | Yes |
Addresses
Primary practice location
8842 State Route 90 N
King Ferry, NY 13081-8717
Mailing address
8842 State Route 90 N
King Ferry, NY 13081-8717
Phone (315) 364-7570
Other providers in King Ferry, NY
- Karla Eshelman
- Elizabeth H Foster
- Sherry R Gebczyk
- Gentry Nurse Practitioner in Family Health
- Robert Maurice Godbout
- Libby Danielle Kershner
- Thomas J Laclair
- Lifespan PT OT &SLP Services PLLC
- Kirsta R Malone
- Mandel Therapy Group
All providers in King Ferry, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.