Provider Demographics
NPI:1871076067
Name:RAGUSA, REBECCA MARIE (MA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:RAGUSA
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 1:170 UDALL RD
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-2338
Mailing Address - Country:US
Mailing Address - Phone:718-445-3232
Mailing Address - Fax:
Practice Address - Street 1:14726 25TH DR
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1420
Practice Address - Country:US
Practice Address - Phone:718-445-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist