Provider Demographics
NPI:1528353737
Name:MARINO, MELISSA ANN (MS SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:MARINO
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 1:255 EXECUTIVE DR STE LL108
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1707
Mailing Address - Country:US
Mailing Address - Phone:845-430-1033
Mailing Address - Fax:
Practice Address - Street 1:255 EXECUTIVE DR STE LL108
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1707
Practice Address - Country:US
Practice Address - Phone:845-430-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020944-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist