Provider Demographics
NPI:1144456336
Name:MORALES, ASSUNTA (MS/SLP)
Entity type:Individual
Prefix:MRS
First Name:ASSUNTA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N BURLING LN
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-3307
Mailing Address - Country:US
Mailing Address - Phone:631-793-1232
Mailing Address - Fax:
Practice Address - Street 1:933 GOODRICH ST
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2400
Practice Address - Country:US
Practice Address - Phone:516-918-1850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017253-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist