Provider Demographics
NPI:1417745985
Name:BARTOLOMUCCI, ROLAND (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ROLAND
Middle Name:
Last Name:BARTOLOMUCCI
Suffix:
Gender:
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ORIOLE ST
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2711
Mailing Address - Country:US
Mailing Address - Phone:845-826-2893
Mailing Address - Fax:
Practice Address - Street 1:500 WESTERN HWY
Practice Address - Street 2:
Practice Address - City:BLAUVELT
Practice Address - State:NY
Practice Address - Zip Code:10913-2022
Practice Address - Country:US
Practice Address - Phone:845-359-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013958235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty