Provider Demographics
NPI:1699082669
Name:LOFRESE, DEANNA L (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:L
Last Name:LOFRESE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:DEANNA
Other - Middle Name:L
Other - Last Name:SYSKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:53 GIBSON ROAD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6709
Mailing Address - Country:US
Mailing Address - Phone:914-462-2921
Mailing Address - Fax:
Practice Address - Street 1:53 GIBSON RD
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6709
Practice Address - Country:US
Practice Address - Phone:914-462-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-11
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020597-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist