Provider Demographics
NPI:1447542378
Name:RIOLO, RACHEL E (SLP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:E
Last Name:RIOLO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:E
Other - Last Name:GARGUILO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4747 MIDDLE SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-4983
Mailing Address - Country:US
Mailing Address - Phone:315-793-8580
Mailing Address - Fax:
Practice Address - Street 1:2050 TILDEN AVE
Practice Address - Street 2:BOX 1000
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-3613
Practice Address - Country:US
Practice Address - Phone:315-797-3114
Practice Address - Fax:315-624-0474
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020901-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01815543Medicaid
NY00313539Medicaid
NY334526Medicare Oscar/Certification
NY335475Medicare Oscar/Certification