Provider Demographics
NPI:1255618617
Name:AVERSANO, NORMA (MA)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:
Last Name:AVERSANO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 MANOR ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2305
Mailing Address - Country:US
Mailing Address - Phone:914-243-8140
Mailing Address - Fax:
Practice Address - Street 1:2901 MANOR ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2305
Practice Address - Country:US
Practice Address - Phone:914-243-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006054235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist