Provider Demographics
NPI:1215312095
Name:DAGUANNO, EMMA R (MS ED, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:EMMA
Middle Name:R
Last Name:DAGUANNO
Suffix:
Gender:F
Credentials:MS ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NEW KARNER RD
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-9578
Mailing Address - Country:US
Mailing Address - Phone:631-790-9025
Mailing Address - Fax:
Practice Address - Street 1:10 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-9578
Practice Address - Country:US
Practice Address - Phone:631-790-9025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
NY025746-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05269925Medicaid