MEDICARE: MS. CLAUDIA LAGARES M.A. 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	013609-1	NY

General Provider Information

NPI Number	:	1336450915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLAUDIA LAGARES M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	16-19 BELLAIR AVE
Second Line	:
City	:	FAIR LAWN
State	:	NJ
Zip	:	07410-2177
Country	:	US
Telephone Number	:	646-734-3073
Fax Number	:

Provider Business Practice Location Address
First Line	:	4951 CHAMBERS STREET
Second Line	:	6TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10007-1209
Country	:	US
Telephone Number	:	646-734-3073
Fax Number	:

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

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	06/29/2010

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