Provider Demographics
NPI:1861620445
Name:DIGIAMBATTISTA, KRISTINE C (SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:C
Last Name:DIGIAMBATTISTA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:KRISTINE
Other - Middle Name:C
Other - Last Name:COSCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:240 HURSTBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-5513
Mailing Address - Country:US
Mailing Address - Phone:585-746-5799
Mailing Address - Fax:
Practice Address - Street 1:750 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-1230
Practice Address - Country:US
Practice Address - Phone:585-966-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0179351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist