Provider Demographics
NPI:1720283575
Name:DE MARINIS CUNNINGHAM, REGINA A (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:A
Last Name:DE MARINIS CUNNINGHAM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:REGINA
Other - Middle Name:A
Other - Last Name:DE MARINIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:113 PLITT AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-5144
Mailing Address - Country:US
Mailing Address - Phone:516-642-7577
Mailing Address - Fax:
Practice Address - Street 1:113 PLITT AVE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-5144
Practice Address - Country:US
Practice Address - Phone:516-642-7577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011904235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist