Provider Demographics
NPI:1154574481
Name:ROSA-FARLEIGH, PATTI (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:ROSA-FARLEIGH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HEMLOCK LN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1104
Mailing Address - Country:US
Mailing Address - Phone:518-482-5944
Mailing Address - Fax:
Practice Address - Street 1:20 HEMLOCK LN
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1104
Practice Address - Country:US
Practice Address - Phone:518-482-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist