Provider Demographics
NPI:1174772776
Name:AMADOR-CORTES, ROSA ELENA (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:ELENA
Last Name:AMADOR-CORTES
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 HALLIDAY RD.
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727
Mailing Address - Country:US
Mailing Address - Phone:631-696-8038
Mailing Address - Fax:631-590-5847
Practice Address - Street 1:33 HALLIDAY RD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-3024
Practice Address - Country:US
Practice Address - Phone:631-872-8925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014558-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist