Mrs. Nicole Provornov
Speech-Language Pathologist, in Trumbull, Connecticut
1366872129- Practice location
- 4291 Madison Ave, Trumbull, CT 06611-2739
- Phone
- 917-385-7655
- Fax
- —
- Last updated
- March 10, 2021
Nicole Provornov is a Speech-Language Pathologist, based in Trumbull, CT. Nicole Provornov practices in Trumbull, CT. The NPI Number for Nicole Provornov is 1366872129 and holds a License No. 58022604 (NY). The current practice location address for Nicole Provornov is 4291 Madison Ave, Trumbull, CT 06611-2739 and can be reached out via phone at 917-385-7655.
Provider Profile Details
- NPI Number
- 1366872129
- Provider Name
- Nicole Provornov
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 4291 Madison Ave, Trumbull, CT 06611-2739
- Phone Number
- 917-385-7655
- Primary Taxonomy
- Speech-Language Pathologist, · 235Z00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- November 14, 2013
- Last Update Date
- March 10, 2021
- Certification Date
- March 10, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 4291 Madison Ave
Trumbull, CT 06611-2739 - City
- Trumbull
- State
- Connecticut
- Zip
- 06611-2739
- Phone Number
- 917-385-7655
Provider Business Mailing Address Details
- Address
- 4291 Madison Ave
Trumbull, CT 06611-2739 - City
- Trumbull
- State
- CT
- Zip
- 06611-2739
- Phone Number
- 917-385-7655
License Information
- License Number
- 58022604
- License State
- NY
- Taxonomy
- Speech-Language Pathologist, · 235Z00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Speech-Language Pathologist, providers near Trumbull, CT
View all Speech-Language Pathologist, providers in Trumbull →- Alexis V PossidentoSpeech-Language Pathologist, · NPI 1619702198
- Amy L Ginter, MA, CCC-SLPSpeech-Language Pathologist, · NPI 1740446251
- Ashley DenunzioSpeech-Language Pathologist, · NPI 1407238314
- Astrid ToribioSpeech-Language Pathologist, · NPI 1790328458
- Carson Leonstein, MS, CCC-SLPSpeech-Language Pathologist, · NPI 1235945395
- Gail M Kay, MS, CCC-SLPSpeech-Language Pathologist, · NPI 1861272676
Frequently Asked Questions
What is the NPI number of Mrs. Nicole Provornov?
The NPI number of Mrs. Nicole Provornov is 1366872129. It was assigned on November 14, 2013 and is currently active in the NPPES registry.
What is the specialty of Mrs. Nicole Provornov?
Mrs. Nicole Provornov is registered under the primary taxonomy Speech-Language Pathologist, (code 235Z00000X), licensed in NY under license number 58022604.
Where does Mrs. Nicole Provornov practice?
The practice location is 4291 Madison Ave, Trumbull, CT 06611-2739. The office can be reached at 917-385-7655 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1366872129 directly on the NPPES registry website.