MEDICARE: MS. BONNIE L MIGDEN 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

General Provider Information

NPI Number	:	1417260761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BONNIE L MIGDEN M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	2420 PARSONS BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11357-3444
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 PARSONS BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11357-3444
Country	:	US
Telephone Number	:	516-574-9991
Fax Number	:

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

Provider Enumeration Date	:	07/15/2010
Last Update Date	:	11/01/2010

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Directions to “ MS. BONNIE L MIGDEN M.A., CCC-SLP” Practice Location

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