Provider Demographics
NPI:1750695813
Name:BORRAZZO, RAFFAELLA (SLP)
Entity type:Individual
Prefix:MRS
First Name:RAFFAELLA
Middle Name:
Last Name:BORRAZZO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1730
Mailing Address - Country:US
Mailing Address - Phone:914-414-6390
Mailing Address - Fax:
Practice Address - Street 1:377 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1730
Practice Address - Country:US
Practice Address - Phone:914-414-6390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019216-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist