Provider Demographics
NPI:1306091004
Name:MARINELLO-DIMINO, SILVIA (MACCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SILVIA
Middle Name:
Last Name:MARINELLO-DIMINO
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HANNAH MOUNT DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-1723
Mailing Address - Country:US
Mailing Address - Phone:347-661-1515
Mailing Address - Fax:
Practice Address - Street 1:7 HANNAH MOUNT DR
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08510-1723
Practice Address - Country:US
Practice Address - Phone:347-661-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012267235Z00000X
NJ4366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist