Provider Demographics
NPI:1952469066
Name:DEFEO, DOROTHY (MA)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:DEFEO
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 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5187
Mailing Address - Country:US
Mailing Address - Phone:143-335-8019
Mailing Address - Fax:
Practice Address - Street 1:1307 WHITE HORSE RD
Practice Address - Street 2:BUILDING A, SUITE 100
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2176
Practice Address - Country:US
Practice Address - Phone:856-346-0200
Practice Address - Fax:856-309-8192
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00048100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist