Provider Demographics
NPI:1972382646
Name:ALESI, VICTORIA LYNN (MA CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:ALESI
Suffix:
Gender:F
Credentials:MA CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CARLIN DR
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-1112
Mailing Address - Country:US
Mailing Address - Phone:631-578-9907
Mailing Address - Fax:
Practice Address - Street 1:196 N BELLE MEAD RD STE 3
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3477
Practice Address - Country:US
Practice Address - Phone:631-909-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033378-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist