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NPI Code Detail

MEDICARE: JULIE ANNE WANAMAKER MS, CCC-SLP

MEDICARE: JULIE ANNE WANAMAKER 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 Pathologist026991NY

General Provider Information

NPI Number : 1215448873
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE ANNE WANAMAKER MS, CCC-SLP
Provider Business Mailing Address
First Line : 243 78TH ST APT 3F
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-3029
Country : US
Telephone Number : 646-823-4386
Fax Number :
Provider Business Practice Location Address
First Line : 1025 EASTERN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-4601
Country : US
Telephone Number : 718-363-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2017
Last Update Date : 10/22/2017

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Directions to “ JULIE ANNE WANAMAKER MS, CCC-SLP” Practice Location

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