Basic Information
| Provider Information | |||||||||
| NPI: | 1689146003 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAMBINELLI | ||||||||
| FirstName: | DENISE | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | M.S. ED. CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 WARREN CT | ||||||||
| Address2: | |||||||||
| City: | CORNWALL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125182147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456498353 | ||||||||
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| Practice Location | |||||||||
| Address1: | 70 DUBOIS ST | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125504851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455614400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/24/2018 | ||||||||
| LastUpdateDate: | 12/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 027930-1 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.