Provider Demographics
NPI:1306120225
Name:TENAGLIA, VERONICA ANDREA
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:ANDREA
Last Name:TENAGLIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10226 RHYDER RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-4486
Mailing Address - Country:US
Mailing Address - Phone:646-641-5174
Mailing Address - Fax:
Practice Address - Street 1:6541 SAUNDERS ST
Practice Address - Street 2:APT 1E
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:646-641-5174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020802-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist