Provider Demographics
NPI:1699058339
Name:NAPOLITANO, LORI ANNE (MACCCSLP)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANNE
Last Name:NAPOLITANO
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BERKSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1906
Mailing Address - Country:US
Mailing Address - Phone:631-928-1490
Mailing Address - Fax:
Practice Address - Street 1:55 OTSEGO AVE
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6435
Practice Address - Country:US
Practice Address - Phone:631-592-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011779-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist