Alisha Marie Constantino, M.S. CCC SLP

Individual provider Active NPI Speech-Language Pathologist · E. Setauket, NY

NPI 1790076529 · NPPES record last updated Apr 27, 2011

Key facts

NPI
1790076529
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
010270-1 (NY)
Practice address
5 Sawyer Court
E. Setauket, NY 11733
Phone
(631) 941-9816
NPI assigned
Apr 27, 2011
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

LicenseStateTypeSpecialty
010270-1NYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 010270-1 NY Yes

Addresses

Primary practice location

5 Sawyer Court
E. Setauket, NY 11733

Mailing address

5 Sawyer Court
E. Setauket, NY 11733
Phone (631) 941-9816

Other names

  • Alisha Marie Foggo Other name

Other providers in E. Setauket, NY

All providers in E. Setauket, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.