MEDICARE: AIDA JUNIK

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	014187	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	014187	OTHER	NY	NYS SPEECH - LANGUAGE PATHOLOG

General Provider Information

NPI Number	:	1275874463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIDA JUNIK

Provider Business Mailing Address
First Line	:	354 CROWN ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3006
Country	:	US
Telephone Number	:	718-755-3579
Fax Number	:

Provider Business Practice Location Address
First Line	:	354 CROWN ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-3006
Country	:	US
Telephone Number	:	718-755-3579
Fax Number	:

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

Provider Enumeration Date	:	03/13/2013
Last Update Date	:	03/13/2013

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Directions to “ AIDA JUNIK ” Practice Location

Language	Start Address	Practice Location

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