MEDICARE: MRS. MARIA PAPANTONIS 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	015377	NY

General Provider Information

NPI Number	:	1043528938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA PAPANTONIS CCC-SLP

Provider Business Mailing Address
First Line	:	2 ROSCOE CT
Second Line	:
City	:	GREENVALE
State	:	NY
Zip	:	11548-1143
Country	:	US
Telephone Number	:	917-704-8231
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 36TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-5117
Country	:	US
Telephone Number	:	718-626-2598
Fax Number	:

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

Provider Enumeration Date	:	09/14/2010
Last Update Date	:	05/17/2021

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Directions to “ MRS. MARIA PAPANTONIS CCC-SLP” Practice Location

Language	Start Address	Practice Location

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