Provider Demographics
NPI:1962789024
Name:SACCO-VONATZINGEN, DEBORAH J (MS SLP CCC)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:J
Last Name:SACCO-VONATZINGEN
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:VONATZINGEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS SLP CCC
Mailing Address - Street 1:504 IRVING RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12083-3908
Mailing Address - Country:US
Mailing Address - Phone:518-966-4626
Mailing Address - Fax:
Practice Address - Street 1:504 IRVING RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12083-3908
Practice Address - Country:US
Practice Address - Phone:518-966-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003354-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist