Denise Boniface, SLP

Individual provider Active NPI Speech-Language Pathologist · East Greenbush, NY

NPI 1871870477 · NPPES record last updated Nov 10, 2011

Key facts

NPI
1871870477
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
016408-1 (NY)
Practice address
29 Englewood Ave
East Greenbush, NY 12061-3900
Phone
(518) 207-2500
NPI assigned
Nov 10, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
016408-1NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 016408-1 NY Yes

Addresses

Primary practice location

29 Englewood Ave
East Greenbush, NY 12061-3900

Mailing address

32 Ridge Road
Rensselaer, NY 12144
Phone (518) 479-3488

Other providers in East Greenbush, NY

All providers in East Greenbush, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.