MEDICARE: MS. DEBORAH S. GROARK 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	0073781	NY

General Provider Information

NPI Number	:	1205081668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH S. GROARK MA,CCC/SLP

Provider Business Mailing Address
First Line	:	270 SHORE RD
Second Line	:	APT. 30
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4237
Country	:	US
Telephone Number	:	516-889-4691
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 SHORE RD
Second Line	:	APT. 30
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4237
Country	:	US
Telephone Number	:	516-889-4691
Fax Number	:

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

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	11/25/2008

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Directions to “ MS. DEBORAH S. GROARK MA,CCC/SLP” Practice Location

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