Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Regina Ann Provisiero, MA/CCC/SLP

Individual provider Speech-Language Pathologist · NPI 1457596207

Miss. Regina Ann Provisiero, MA/CCC/SLP is a Qualified Speech Language Pathologist in Port Jefferson, New York. Qualified in 2014, 12 years ago. Practices with Sensory Solutions of Long Island Inc, a 2-clinician group. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2008
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Practice location Address checks out

220 Windward Ct N
Port Jefferson, NY 11777-2323
Phone: (631) 525-7514
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 58017705 (NY)

Record details

NPI number1457596207
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA/CCC/SLP
Sole proprietorNo
NPI enumeratedDecember 9, 2008
Last updated in NPPESDecember 9, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Sensory Solutions Of Long Island Inc — 2 clinicians
Accepts Medicare assignment Not indicated

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