Provider Demographics
NPI:1487132304
Name:LUONGO, JULIE (TSHH)
Entity type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:
Last Name:LUONGO
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:GUERRIERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:TSHH
Mailing Address - Street 1:9435 120TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1305
Mailing Address - Country:US
Mailing Address - Phone:347-489-5161
Mailing Address - Fax:
Practice Address - Street 1:3636 33RD ST STE 500
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-2329
Practice Address - Country:US
Practice Address - Phone:212-529-9870
Practice Address - Fax:212-529-9866
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2355S0801X
NY3254612355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY325461Medicaid