MEDICARE: TWIN DRAGON CONSULTING SERVICE,INC

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	252Y00000X	Early Intervention Provider Agency	0132031	NY

General Provider Information

NPI Number	:	1215368576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN DRAGON CONSULTING SERVICE,INC

Provider Business Mailing Address
First Line	:	28 STIRRUP LN
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-2516
Country	:	US
Telephone Number	:	917-257-4086
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 STIRRUP LN
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-2516
Country	:	US
Telephone Number	:	917-257-4086
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JIAYE XIE
Credential	:	SLP
Telephone Number	:	917-257-4086

Provider Enumeration Date	:	12/11/2013
Last Update Date	:	12/11/2013

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