MEDICARE: SABRA GELFOND 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	2051	MD

General Provider Information

NPI Number	:	1487889127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRA GELFOND CCC SLP

Provider Business Mailing Address
First Line	:	5606 SHIELDS DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-3571
Country	:	US
Telephone Number	:	301-493-0023
Fax Number	:

Provider Business Practice Location Address
First Line	:	5606 SHIELDS DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-3571
Country	:	US
Telephone Number	:	301-493-0023
Fax Number	:

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

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	04/11/2018

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