Provider Demographics
NPI:1053566638
Name:GERMANO, CAROL ANN (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CAROL ANN
Middle Name:
Last Name:GERMANO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:CAROL ANN
Other - Middle Name:
Other - Last Name:GERMANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:65 LINCOLN BLVD
Mailing Address - Street 2:F12
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4432
Mailing Address - Country:US
Mailing Address - Phone:516-897-9039
Mailing Address - Fax:
Practice Address - Street 1:65 LINCOLN BLVD
Practice Address - Street 2:F12
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4447
Practice Address - Country:US
Practice Address - Phone:516-897-9039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008638-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist