Provider Demographics
NPI:1679130355
Name:DELUCA, PATRICIA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:DELUCA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:GENCARELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1029 CELLAR AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-3161
Mailing Address - Country:US
Mailing Address - Phone:201-532-1078
Mailing Address - Fax:
Practice Address - Street 1:1029 CELLAR AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-3161
Practice Address - Country:US
Practice Address - Phone:201-532-1078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00834000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist