Provider Demographics
NPI:1780722363
Name:ANNUNZIATO, DEANNE ELIA (SLP)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:ELIA
Last Name:ANNUNZIATO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3466
Mailing Address - Country:US
Mailing Address - Phone:203-234-2479
Mailing Address - Fax:
Practice Address - Street 1:20 WINCHESTER DR
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3466
Practice Address - Country:US
Practice Address - Phone:203-234-2479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist