Provider Demographics
NPI:1316946643
Name:GIACOPELLI, DINA T (MS-CCC-A)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:T
Last Name:GIACOPELLI
Suffix:
Gender:F
Credentials:MS-CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 HEMPSTEAD TPKE
Mailing Address - Street 2:STE 200
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1341
Mailing Address - Country:US
Mailing Address - Phone:516-731-6644
Mailing Address - Fax:516-731-8746
Practice Address - Street 1:2870 HEMPSTEAD TPKE
Practice Address - Street 2:STE 200
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1341
Practice Address - Country:US
Practice Address - Phone:516-731-6644
Practice Address - Fax:516-731-8746
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYO01468231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM22162Medicare ID - Type Unspecified