Provider Demographics
NPI:1861535023
Name:CRECCO, DARA ANN (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:ANN
Last Name:CRECCO
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:ANN
Other - Last Name:LOMBARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:258 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1024
Mailing Address - Country:US
Mailing Address - Phone:516-385-6623
Mailing Address - Fax:
Practice Address - Street 1:258 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1024
Practice Address - Country:US
Practice Address - Phone:516-385-6623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0155571235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist