MEDICARE: MRS. ALISON A GIMBERLEIN MA CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	014026-1	NY

General Provider Information

NPI Number	:	1023144169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALISON A GIMBERLEIN MA CCC-SLP

Provider Business Mailing Address
First Line	:	14 IVY ST
Second Line	:	6A
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-2355
Country	:	US
Telephone Number	:	631-816-1089
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 JAMES ST
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-2808
Country	:	US
Telephone Number	:	631-669-8255
Fax Number	:	631-321-6645

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2007
Last Update Date	:	07/08/2007

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Directions to “ MRS. ALISON A GIMBERLEIN MA CCC-SLP” Practice Location

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