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NPI Code Detail

MEDICARE: ILEANA LESCANO MS/CCC/SLP

MEDICARE: ILEANA LESCANO MS/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
1235Z00000XSpeech-Language Pathologist0082351NY

General Provider Information

NPI Number : 1154621936
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILEANA LESCANO MS/CCC/SLP
Provider Business Mailing Address
First Line : 2 GRIDLEY AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2204
Country : US
Telephone Number : 718-448-7774
Fax Number : 718-448-8196
Provider Business Practice Location Address
First Line : 2 GRIDLEY AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2204
Country : US
Telephone Number : 718-448-7774
Fax Number : 718-448-8196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2010
Last Update Date : 11/28/2011

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Directions to “ ILEANA LESCANO MS/CCC/SLP” Practice Location

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