MEDICARE: MRS. ELIZABETH MARY RIGNEY 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
1	235Z00000X	Speech-Language Pathologist	013558-01	NY

General Provider Information

NPI Number	:	1225283997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH MARY RIGNEY MS, CCC-SLP

Provider Business Mailing Address
First Line	:	6 HIGH ST
Second Line	:	PO BOX 471
City	:	ROUND LAKE
State	:	NY
Zip	:	12151
Country	:	US
Telephone Number	:	518-899-0039
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 HIGH ST
Second Line	:
City	:	ROUND LAKE
State	:	NY
Zip	:	12151
Country	:	US
Telephone Number	:	518-899-0039
Fax Number	:

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

Provider Enumeration Date	:	11/23/2008
Last Update Date	:	11/23/2008

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