Provider Demographics
NPI:1790510071
Name:PAMPILLONIA, ISABELLA AMELIA
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:AMELIA
Last Name:PAMPILLONIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 E EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-4722
Mailing Address - Country:US
Mailing Address - Phone:516-375-4465
Mailing Address - Fax:
Practice Address - Street 1:252 W 76TH ST STE 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-8227
Practice Address - Country:US
Practice Address - Phone:212-430-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist