Provider Demographics
NPI:1174955223
Name:PROIETTI, BRIDGETTE ROSE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:ROSE
Last Name:PROIETTI
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 1:958 MADISON AVE
Mailing Address - Street 2:5F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2636
Mailing Address - Country:US
Mailing Address - Phone:732-977-2488
Mailing Address - Fax:
Practice Address - Street 1:958 MADISON AVE
Practice Address - Street 2:5F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2636
Practice Address - Country:US
Practice Address - Phone:732-977-2488
Practice Address - Fax:732-977-2488
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60339500235Z00000X
NY023789235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist