Provider Demographics
NPI:1306992631
Name:LOSITO, CELESTE MARIE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:MARIE
Last Name:LOSITO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 CARLL DR
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6220
Mailing Address - Country:US
Mailing Address - Phone:631-647-7162
Mailing Address - Fax:
Practice Address - Street 1:8 SWENSON DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1223
Practice Address - Country:US
Practice Address - Phone:516-921-5292
Practice Address - Fax:516-921-5273
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011913-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist