Provider Demographics
NPI:1003196007
Name:BELLANTUONO, KRISTINA (MA)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:BELLANTUONO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:BELLANTUONO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:112 N PINE TER
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-4052
Mailing Address - Country:US
Mailing Address - Phone:917-907-2316
Mailing Address - Fax:
Practice Address - Street 1:112 N PINE TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-4052
Practice Address - Country:US
Practice Address - Phone:917-907-2316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist