Provider Demographics
NPI:1306625066
Name:RISE & SHINE THERAPY LLC
Entity type:Organization
Organization Name:RISE & SHINE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC- SLP
Authorized Official - Phone:917-622-1842
Mailing Address - Street 1:266A MATCHAPONIX AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4096
Mailing Address - Country:US
Mailing Address - Phone:917-622-1842
Mailing Address - Fax:
Practice Address - Street 1:266A MATCHAPONIX AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-4096
Practice Address - Country:US
Practice Address - Phone:917-622-1842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1003126871OtherSOLE PROPRIETOR