Provider Demographics
NPI:1386926210
Name:SANTAMARINA, EMILY M (MA CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:M
Last Name:SANTAMARINA
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 SHEPHERD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2248
Mailing Address - Country:US
Mailing Address - Phone:516-393-5263
Mailing Address - Fax:516-393-5265
Practice Address - Street 1:140 SHEPHERD ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2248
Practice Address - Country:US
Practice Address - Phone:516-393-5263
Practice Address - Fax:516-393-5265
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016119235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist