MEDICARE: MISS AMANDA FERRARO CCC-SLP, TSSLD

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	027649	NY

General Provider Information

NPI Number	:	1255824082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS AMANDA FERRARO CCC-SLP, TSSLD

Provider Business Mailing Address
First Line	:	1875 E 17TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2912
Country	:	US
Telephone Number	:	718-645-1334
Fax Number	:

Provider Business Practice Location Address
First Line	:	1875 E 17TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229
Country	:	US
Telephone Number	:	718-645-1334
Fax Number	:

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	02/24/2020

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