Provider Demographics
NPI:1154909810
Name:DILLUVIO, MARIANNA (MS, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:DILLUVIO
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15022 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3645
Mailing Address - Country:US
Mailing Address - Phone:646-639-1603
Mailing Address - Fax:
Practice Address - Street 1:349 CABRINI BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3605
Practice Address - Country:US
Practice Address - Phone:212-927-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030550-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist