Provider Demographics
NPI:1306081708
Name:MASTRANGELO, NOREEN A (SLP)
Entity type:Individual
Prefix:MS
First Name:NOREEN
Middle Name:A
Last Name:MASTRANGELO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:NOREEN
Other - Middle Name:A
Other - Last Name:SCANLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3134 CORLEAR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3938
Mailing Address - Country:US
Mailing Address - Phone:718-549-7475
Mailing Address - Fax:
Practice Address - Street 1:3134 CORLEAR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3938
Practice Address - Country:US
Practice Address - Phone:718-549-7475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-13
Last Update Date:2008-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016253-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist